凉山地区小儿脓毒血症病原菌分布及药物敏感性分析

目的分析凉山地区小儿脓毒血症病原菌分布及药敏情况,指导临床合理使用抗生素。方法回顾性分析经血培养分离出的385株阳性菌株的构成比及药敏状况。结果 385株中G＋菌84.9%;G-菌15.1%。前6位病原菌为凝固酶阴性葡萄球菌（CNS）（66.5%）、沙门菌（6.2%）、肠球菌属（5.2%）、非发酵菌属（4.2%）、大肠埃希菌（3.1%）、金黄色葡萄球菌（3.1%）。大多数G＋菌对万古霉素、利福平、哌拉西林/他唑巴坦、喹诺酮类敏感。G-杆菌中沙门菌对亚胺培南、氨曲南、三代头孢菌素、酶抑制剂复方制剂、喹诺酮类、复方新诺明敏感;大肠埃希菌多重耐药。结论 CNS是本地区小儿脓毒血症的主要病原菌,不同病原菌的药敏状况差异大。万古霉素、利福平、亚胺培南、氨曲南、3代头孢菌素、阿米卡星及喹诺酮类目前仍为主要敏感抗生素。

The distribution and analysis of drug susceptibifity of pathogens causing pyemia in children in Liangshan

Objective To analyze the distribution and drug susceptibility of the pathogens causing pyemia in children in Liangshan,and to guide the rational use of antibiotics.Methods Retrospective analysis was conducted on the constituent ratio and drug susceptibility to antibiotics of 385 positive strains cultured and isolated by using pediatric blood.Results In the 385 positive strains,G＋ bacteria was 84.9% and G-bacteria（15.1%）.The first 6 pathogens were coagulase-negative staphylococci（CNS）（66.5%）,Salmonella（6.2%）,Enterococcus（5.2%）,Non-fermenting bacteria（4.2%）,Escherichia coli（3.1%）,Staphylococcus aureus（S.aureus for short）（3.1%）.Most G＋ bacteria were sensitive to vancomycin,rifampicin,piperacillin/tazobactam,quinolones.Salmonella in G-bacillus maintained a high degree of sensitivity to imipenem,aztreonam and third generation cephalosporins,the compound preparation of enzyme inhibitor,quinolones,cotrimoxazole.Escherichia coli was multidrug resistant.Conclusion CNS is the main pathogen of infant sepsis.The drug susceptibility of different pathogens is significantly different.Vancomycin,rifampin,imipenem,aztreonam,the third-generation cephalosporins,amikacin and fluoroquinolones are currently still sensitive antibiotics.