儿童53例败血症病原学分析及细菌耐药监测

目的：探讨近年儿童败血症的病原学分布及其对抗生素的耐药情况。方法：对我院1998年1月至2000年11月53例儿童败血症的临床资料、血培养及药敏试验结果进行回顾性分析。结果：病原菌以葡萄球菌属检出率最高，占47.2％，其中金葡球菌占13.2％，表皮葡萄球菌占22.6％，革兰氏阴性杆菌中以大肠埃希氏菌、肺炎克雷伯氏菌、铜绿假单胞菌为主，分别占检出菌的9.4%、7.5％、7.5％。葡萄球菌对青霉素G的耐药率达96.0％，其中金葡球菌高达100.0％，对红霉素的耐药率达80.0％，绝大多数革兰氏阳性菌对环丙沙星及万古霉素敏感，已发现耐万古霉素的表皮葡萄球菌菌株。大多数革兰氏阴性杆菌对环丙沙星、亚胺培南敏感。结论：重视儿科感染性疾病的病原菌分布特点及对其耐药性监测是合理使用抗生素，减少细胞耐药现象发生的重要环节。

Pathogenic analysis and antimicrobial resistance monitoring 53 children with septicemia

Objective To investigate the pathogenic distribution and antimicrobial resistance of septicemia in 53 children. Methods Clinical data, results of blood culture and antibiotic susceptibility test of 53 patients with septicemia treated from January 1998 to November 2000 were studied retrospectively. Results The most common microorganism was Staphylococcus which account for 47.2%. The positive rate of S.aureus and S.epidermidis were 13.2% and 22.6% respectively. Escherichia coli, Klebsiella pneumoniae , and P.aeruginosa were the main microorganism in gram-negative bacilli, the positive rate was 9.4%, 7.5% and 7.5% respectively . The resistant rate of Staphylococcus to penicillin was 96%. Among these the resistant rate of S.aureus was up to 100% and its resistant rate to erythromycin was 80.0%, most of gram-positive bacteria were susceptible to ciprofloxacin and vancomycin, but one strain of S.epidermidis resistant to vancomycin was found, most of gram-negative bacilli were susceptible to ciprofloxacin and imipenem. Conclusion We must attach importance to the distribution feature of pathogen of infective diseases in pediatrics and monitor antimicrobial resistance for rational administration of antibiotic and reducing tolerance of antibiotic.