新乡市第一人民医院儿科1997年至2008年急性感染性疾病的耐药性变迁

目的 了解新乡市第一人民医院儿科1997年1月至2008年9月急性感染性疾病主要病原菌分布及耐药情况.方法 采用全自动微生物鉴定系统及纸片扩散法(K-B法)对2 733株菌株进行药敏试验.结果 在2 733株病原菌中革兰阴性菌占59.4%,革兰阳性菌占36.4%,真菌占4.2%.对大肠埃希菌、肺炎克雷白菌、铜绿假单胞菌高度敏感抗菌药物为亚胺培南、多粘菌素.革兰阳性菌中占前三位的为金黄色葡萄球菌、凝固酶阴性葡萄球菌和肺炎链球菌,是儿童急性感染的主要菌群.耐甲氧西林凝固酶阴性葡萄球菌的比例逐年升高,2005年至2006年、2007年至2008年与2001年至2002年相比均有显著性差异(P=0.003或P=0.024).耐药率较低的抗菌药物为万古霉素、亚胺培南等.金黄色葡萄球菌多对青霉素、红霉素和阿奇霉素产生耐药性,且耐药率近年有普遍增高趋势.凝固酶阴性葡萄球菌耐药率逐年增高趋势尤其明显.肺炎链球菌对青霉素、红霉素、阿奇霉素、诺氟沙星、罗红霉素等高度耐药.结论 对儿童急性感染性疾病在用药前应尽快做细菌培养及药敏试验以指导临床合理使用抗生素,从而有利于减少耐药菌株的产生.

Drug resistance diversity of children acute infective disease in the First Hospital of Xinxiang City from 1997 to 2008

Objective To explore the main pathogen distribution and drug resistance analysis of children acute infective disease in Xinxiang Hospital from 1997 to 2008.Methods We adopted full-automatic animalcule identification system and the drug sensitivity test by disc diffusion(KB methods)to identify pathogen in 2 733 specimen.Results In 2 733 specimen,Gram-negative bacteria were accounted for 59.4%,Gram-positive bacteria 36.4%,and epiphyte 4.2%.The antibiotics of high sensitivity to Escherichia coli,Klebsieila pneumoniae,Pseufomonsd aeruginosa,which were high resistance rate for ampieiUin,were imipenem and polymyxin B sulfate.The pathogens of high resistance rate were Staphylococcus aureus,Coagulacenegative staphylococci and Streptococcus pneumoniae in Gram-positive bacteria.They were the main bacteria in acute infective disease.There were remarkable difference of MRCNS infection among 2001-2002,20052006 and 2007-2008(P = 0.003 or 0.024 respectively).The antibiotics of low resistance rate were vancomyin,imipenem,etc.The anterior three antibiotics of high resistance rate to Staphylococcus aureus were peniciline,erythromycin and azithromycin,which had a prevalent trend of high resistance rate recently.The antibiotics of high resistance rate for Streptococcus pneumoniae were peniciline,erythromycin,azithromycin,norfloxacin and rulide,ete.Conclusion Bacteria cultivation and antimicrobial resistance test should be done as soon as possible for children acute infective disease.We should conduct the clinic to use antibiotics reasonably in order to reduce drug resistance.