儿童血液感染的特点分析

目的 分析儿科血液感染的菌种分布及其耐药状况，为临床治疗提供依据。方法对台州市立医院2006年1月1日-9月1日间的儿童血液培养的结果进行回顾性统计分析，从而得出儿童血液感染的菌种分布及耐药情况。结果 儿童血液感染的菌种非常广泛，涉及多种细菌及真菌；排名前五位的分别是葡萄球菌（60．7％）、革兰阳性杆菌（16．9％）、链球菌（6．7％）、肠杆菌科细菌（4．5％）、微球菌（4．5％）。在53株凝固酶阴性葡萄球菌（CNS）中，耐药率低于30％的有：万古霉素（0）、力奈唑烷（0）、莫昔沙星（0）；呋喃妥固（3．8％）、左旋氧氟沙星（5．7％）、利福平（5．7％）、四环素（20．8％）、克林霉素（22．6％）、庆大霉素（22．6％）。在15株革兰阳性杆菌中，耐药率低于30％的有：万古霉素（0）、头孢哌酮（6．7％）、米诺环素（6．7％）和利福平（13．3％）。结论 儿童的血培养阳性率较高（14．3％），以CNS为主。儿童血液感染CNS时首选万古霉素、力奈唑烷和莫昔沙星；次选左旋氧氧沙星、利福平和克林霉素。儿童血液感染革兰阳性杆菌时首选；万古霉素、头孢哌酮和利福平。

Analysis of features of blood infection in children

Objective To investigate the distribution and drug resistance of various bacteria infecting children though blood and provide evidence for clinical treatment.Methods Children's blood were cultured and the drug resistance of bacteria was analyzed from 1 January to 1 September 2006.Results There a variety of bacteria infecting children were identified including bacteria and fungi with Staphylococci(occupied 60.7%)gram positive bacilli(16.9%),Streptococci(6.7%),Enterobacteriaceae spp.(4. 5%)and Micrecocci(4.5%)being on the top of pathogenic microorganisms.The resistance rates of 53 strains of coagulase negative Staphylococcus to vancomycin(0),linezolid(0),moxilloxacin(0),introfurantoin(3.8%),leofloxacin(5.7%),rifampin(5. 7),tetracycline(20.8),elindamycin(22.6)and gentamycin(22.6%)were less than 30%.The resistance rates of 15 gram posi- tive bacilli to antibiotics were also low(being 0 to vancomycin,6.7% to cefoperazone,6.7% to minocycline and 13.3% to ri- famin.Conclusion The positive rate of cultured blood from children is high(14.3%)mainly infected with coagulase negative Staphylococci and Vancomycin,linezolid and moxifloxacin are the drug for first clinical choice,then followed by levofloxacin,ri- fampin and clindamycin.While vancomycin,cefoperazone or rifampin are indicate for treatment of gram positive bacilli infection.