儿童与成人感染的病原菌谱及耐药性分析

目的：比较儿童与成人常见病原菌耐药状况,为临床合理选用抗菌药物提供依据。方法：监测2012年福建省泉州市儿童医院与福建医科大学附属泉州第一医院临床分离细菌耐药状况,以Whonet 5.5软件进行数据分析,比较儿童与成人临床常见病原菌的耐药性差异。结果：从儿童中分离得到致病菌2324株,其中G＋菌945株,占40.66%,G-菌1379株,占59.34%;数量居前6位的分离细菌依次为大肠杆菌、肺炎克雷伯菌、金黄色葡萄球菌、卡他莫拉菌、表皮葡萄球菌和肺炎链球菌。从成人中分离得到致病菌2288株,其中G＋菌743株,占32.47%,G-菌1545株,占67.53%;数量居前6位的分离细菌依次为大肠杆菌、肺炎克雷伯菌、金黄色葡萄球菌、鲍曼不动杆菌、铜绿假单胞菌和肠球菌属。在儿童与成人两组病人中,耐甲氧西林金黄色葡萄球菌（MRSA）的检出率分别为13.9%和19.4%。从儿童中分离的大肠杆菌和肺炎克雷伯菌对阿米卡星和喹诺酮类药物的耐药率要远低于成人,铜绿假单胞菌和鲍曼不动杆菌对抗菌药物的耐药率低于成人,特别是对氨基糖苷类和喹诺酮类药物。结论：儿童常见病原菌的分布和耐药特点与成人存在一定的差异,应持续地进行细菌耐药监测。

Analysis of pathogen spectrum and drug resistance in children and adults

Objective： To compare the drug resistance of common pathogens between children and adults,so as to provide evidence for rational use of antibacterials clinically. Methods： Drug resistance of isolated bacteria from Children＇s Hospital of Quanzhou, and the First Hospital of Quanzhou Affiliated to Fujian Medical University in 2012 were monitored and the data were analyzed by Whonet 5.5 software, and the differences in bacterial drug resistance between children and adults were compared. Results.. A total of 2324 bacteria including 945（40.66%） G＋ strains and 1379（59.34%） G strains were isolated from chil- dren. Escherich ia coil, Klebsiella pneumoniae , Staphylococcus aureus , Moraxella catarrhalis , Staphylococcus e pi dermidis and Streptococcus pneumoniae were the top 6 isolated bacteria in children. A total of 2288 bacteria including 743 （32. 47%） G＋ strains and 1545 （ 67.53%） （7- strains were isolated from adults. E. coli, K. pneumoniae, S. a ureus,A, baumanii, P. aeruginosa and Enterococcus were the top 6 isolated bacteria in adults. The detection rate of meticillin-resistant S. aureus（MRSA） in chil- dren and adults were 13.9% and 19.4% ,respectively. Resistance rates of E. coli and K. pneumoniae in children to amikacin and quinolones were far lower than those in adults, while resistance rates of P. aeruginosa and A. baumannii in children to anti- bacterials, especially aminoglycosides and quinolones were lower than those in adults. Conclusion： There were some differences in distribution and resistant features of bacteria, when comparisons were made between children and adults, and bacterial re- sistance detection should be made continuously.