儿科血流性感染病原菌构成及药敏分析

目的了解儿童血流性感染的病原体构成和药敏情况,以指导临床治疗。方法回顾性分析2009年1月至2012年1月从儿童血液标本中培养出的病原体资料,用WHONET 5.4软件分析病原体的构成情况及其药敏情况。结果共培养出病原菌180株,细菌161株：革兰阳性菌94株,其中葡萄球菌69株;革兰阴性菌67株,其中大肠埃希菌25株,革兰阳性菌主要对万古霉素、替考拉宁、利奈唑烷敏感,而革兰阴性菌对碳青霉烯类抗生素敏感,对常用抗生素如阿莫西林、头孢菌素等存在广泛的耐药。真菌有19株,对两性霉素、伊曲康唑、氟康唑等均敏感。结论血流性感染的病原体构成以革兰氏阳性菌占优势,致病的细菌对青霉素类及头孢类抗生素存在较高耐药性,真菌感染有上升趋势,临床上应合理应用抗生素,根据药敏选择药物,减缓耐药的出现。

The analysis of distribution and sensitivity of etiology of blood infection in children

Objective To investigate the distribution of pathogenic bacteria isolated from blood culture of pediatric patients and observe the antibiotic sensitivity of these bacteria so as to provide the reference for clinical antimicrobial usage.Methods The result of drug susceptibility and distribution of pathogens isolated from blood culture of children were analyzed.The antimicrobial susceptibility rates and pathogens distribution were analyzed by WHONET 5.4 software.Results 180 strains of pathogens were isolated from January 2009 to January 2012,the main pathogenic bacteria included ： 91 strains of Gram positive bacteria consisted of 69 strains of staphylococcus;67 strains of Gram negative bacteria consisted of 25 strains of Escherichia coli.Most of Gram positive bacteria were sensitive to Vancomycin,Tiecoplanin and Linezolid.Most of Gram negative bacillus were sensitive to Carbopenem antibiotics and resistant to most of other antibiotics such as Amoxycillin and the cephalosporin antibiotics.19 strains of fungi were isolated and all of them sensitive to Amphotericin,Itraconazole and Fluconazole.Conclusion Most of bacteria isolated from children with bloodstream infection were Gram positive bacteria.Pathogens were highly resistant to common antibiotics such as Penicillin antibiotics and cephalosporin.The rate of Fungi infection increased.It is important to use antibiotics rationally and according to drug sensitivity test to reduce the occurrence of bacterial resistance.