儿童血培养的病原菌分布及耐药性分析

目的 分析住院患儿血培养的病原菌分布及耐药特点,指导临床抗菌剂的合理应用.方法 采用BACTEC 9240全自动血培养仪和MicroScan WalkAway 96SI全自动微生物鉴定系统进行病原菌的培养和鉴定,用K-B法进行细菌药敏实验.结果 5 750例血培养中379例检出阳性,阳性率为6.59%.共检出病原菌381株,包括革兰阳性菌260株,占68.24%;革兰阴性菌81株,占21.26%;真菌40株,占10.50%.按年龄分组,各年龄段患儿检出的病原菌均以凝固酶阴性葡萄球菌居多,又各有其分布特点;凝固酶阴性葡萄球菌对万古霉素、利奈唑胺和替考拉宁敏感,对β-内酰胺类和大环内酯类耐性率高(>80.00%);大肠埃希菌和肺炎克雷伯菌均未分离出亚胺培南耐药菌株,两者对头孢菌素类抗菌剂耐药严重.结论 儿童血培养分离的病原菌以革兰阳性菌为主,常见的病原菌凝固酶阴性葡萄球菌、大肠埃希菌和肺炎克雷伯菌均对多数常用抗菌剂耐药严重.

Distribution and drug resistance of pathogenic bacteria isolated from blood culture samples of children

Objective To analyze the distribution and drug resistance of pathogenic bacteria isolated from blood culture samples of children.Methods Pathogenic bacteria were cultured and identified by using BACTEC 9240 and MicroScan WalkAway 96SI systems.Drug susceptibility test was performed by using K-B method.Results The total positive rate of bacteria was 6.59%(379/5 750) in all blood culture samples.381 strains of pathogenic bacteria were isolated,including 360 strain(68.24%) of Gram positive bacteria,81 strains(21.26%) of Gram negative bacteria and 40 strains(10.50%) of fungi.In different groups of age,the main pathogenic bacterium was coagulase negative Staphylococcus(CoNS),and different distribution characteristics could be confirmed.CoNS were sensitive to vancomycin,linezolid and teicoplanin,but with high resistance rate to β-lactam and macrolides.No imipenem resistant strain was isolated from Escherichia coli and Klebsiella pneumoniae strains,which were with high resistance rate to cephalosporins.Conclusion Gram positive bacteria might be the main pathogenic bacteria isolated from blood culture samples of children,and the common bacteria,such as CoNS,Escherichia coli and Klebsiella pneumoniae,were with serious resistance to frequently used antibiotics.