摘要
目的调查分析小儿与成人血流感染病原菌的分布及耐药性情况,为临床合理使用抗菌药物提供参考。方法对2012-2017年某三甲医院送检的血培养标本分离的病原菌及其耐药性进行统计分析。结果成人血流感染病原菌共检出1 113株,主要以革兰阴性杆菌为主720株(64.7%),其次为革兰阳性球菌359株(32.3%),真菌24株(2.1%),其他10株(0.9%);小儿血流感染病原菌共检出352株,主要以革兰阳性球菌为主,253株(71.9%),其次为革兰阴性杆菌99株(28.1%)。金黄色葡萄球菌对四环素的耐药性成人为42.3%,高于小儿的23.9%(P≤0.01)。凝固酶阴性葡萄球菌对左氧氟沙星(34.6%vs 19.6%)、环丙沙星(37.7%vs 21.7%)和莫西沙星(66.2%vs 14%)的耐药性,成人高于小儿(P<0.01);对红霉素的耐药性成人为66.2%,低于小儿的81.9%(P<0.01)。大肠埃希菌对头孢唑林(51.6%vs 25.9%)和头孢曲松(45.4%vs 25.9%)的耐药性,成人高于小儿(P≤0.05),产ESBLs大肠埃希菌检出率成人为45.4%,高于小儿的25.9%(P≤0.05)。结论成人与小儿血流感染病原菌的分布不相同,病原菌的耐药结果因小儿用药局限性等因素的影响,也存在一定的差异,临床在治疗血流感染性疾病时,应根据不同年龄群体的病原菌分布,针对性选用抗菌药物,以减缓细菌耐药性的产生。
Objective To investigate and analyze the distribution and drug resistance of pathogenic bacteria of blood influenza in adults and children,and to provide reference for rational use of antibiotics in clinic.Methods The distribution and drug resistance of pathogenic bacteria isolated from blood culture samples of a hospital from 2012 to 2017 were analyzed.Results A total of 1113 strains of bacteria were detected in adult bloodstream infections.Gram-negative bacilli were predominant,with 720 strains（64.7%）,359 strains（32.3%） of Gram-positive cocci,24 strains（2.1%） of fungi and 10 strains（0.9%） of other bacteria.352 strains of pathogens were detected in children with bloodstream infection.352 strains of pathogens were detected in children with bloodstream infection.Among them,gram-positive cocci were the main ones,with 253 strains（71.9%）.Gram-negative bacilli were followed by 99 strains（28.1%）.The resistance rate of Staphylococcus aureus to tetracycline for adults 42.3% was higher than that for children 23.9%（P ≤0.01）.The resistance rates of Coagulase negactive Staphylococcus to levofloxacin（34.6% vs 19.6%）,ciprofloxacin（37.7% vs 21.7%） and moxifloxacin（66.2%vs 14%） for adults were higher than that for children（P〈0.01）.But The resistance rate of Coagulase negactive Staphylococcus to erythromycin for adults（66.2%） was lower than that for children（81.9%）（P〈0.01）.he resistance rates of Escherichia coli to cefazolin（51.6% vs 25.9%） and cefatriaxone（45.4% vs 25.9%） for adults were higher than that for children（P≤0.05）.And the detection rate of ESBLs from Escherichia coli for adults（45.4%） was higher than that for children（25.9%）（P≤0.05）.Conclusion The the distribution and antimicrobial resistance of pathogens from bloodstream infections between adults ang children were different,the limitation of drug use for children maybe cause this result.The antimicrobial agents must be used according to the distribution from the different ages,in order to reduce the selective pressure of ntimicrobial agents.
作者
韩善梅
郑金聪
陈国英
郭良
余振兴
尧义
游霞
HAN Shan-mei;ZHENG Jin-cong;CHEN Guo-ying(Mindong Hospital of Ningde City,Fujian 355000,China)
出处
《临床合理用药杂志》
2018年第32期18-20,共3页
Chinese Journal of Clinical Rational Drug Use
基金
2012年宁德市科技计划项目(No:20120067)
关键词
血流感染
血培养
病原菌
耐药性
Bloodstream infection
Blood culture
Pathogen
Drug resistance
