儿童血流感染中常见病原菌的分布及耐药性分析

目的 回顾性分析儿童血培养病原菌的分布和耐药特点.方法 采用Bact/Alert 3D全自动血培养仪进行血培养,使用VITEK 2 COMPACT细菌鉴定系统进行菌株鉴定和药敏试验.结果 送检的5 358份儿童血培养标本共分离病原菌374株,其中革兰氏阳性菌288株,占77%;革兰氏阴性菌81株,占21.66%;念珠菌5株,占1.34%.耐甲氧西林金黄色葡萄球菌占金黄色葡萄球菌47.1%,耐甲氧西林凝固酶阴性葡萄球菌占凝固酶阴性葡萄球菌72.2%,肠球菌属细菌和肺炎链球菌检出率较高;未检出对万古霉素和利奈唑烷耐药的阳性菌,未见耐碳青霉烯类抗生素的阴性菌.结论 儿童血培养以革兰阳性菌为主,多药耐药菌常见,临床医师要重视药敏结果,严格用药指征,延缓病原菌耐药.

Distribution and drug resistance of pathogenic bacteria in children bloodstream infections

Objective To study the distribution and drug resistance of pathogenic isolated from the children＇s blood culture in the last three years and provide basic for the usage of antimicrobial agents. Methods Blood samples were cultivate by Bact/Alert 3D automated system,while pathogenic bacteria identify and sensitivity test were cultivated by VITEK 2 COMPACT system. Results 374 pathogens were isolated from 5358 blood culture specimens, among which 288 strains （77%） were Gram - positive bacteria, 81 strains （21.66%） were Gram - negative bacteria and 5 strains （ 1.34% ） were yeast. Methicillin - resistant staphylococcus aureus accounted for 47.1% and Methicillin -resistant coagulase negative staphylococcus accounted for 72.2%. Enterococcus bacteria and Streptococcus pneumoniae were the major bacteria isolated from cultures. Gram - positive bacteria were sensitive to Vancomycin and Linezolid. Gram - negative bacteria were sensitive to carbapenem. Conclusion Gram - positive bacteria might be the predominant pathogen in children＇s patients and resistant against various antibiotics. The rational usage of antimicrobial drugs might be very important.