湖北地区儿科患者血培养阳性病原菌的耐药性监测

摘要

目的 了解近年湖北地区三级医院儿科患者血培养中病原菌的分布及其耐药性.方法 收集2006-2007年湖北地区17所三级医院儿科患者血培养阳性分离的病原菌,用常规方法 分离鉴定细菌,药敏试验采用纸片扩散法(K-B法).结果 2006年1-12月血培养分离菌941株,细菌依所占比率多少依次为凝固酶阴性葡萄球菌573株(60.9%),金葡菌127株(13.5%),粪肠球菌33株(3.5%),大肠埃希菌16株(1.7%).2007年1-12月血培养分离菌969株,依次为凝固酶阴性葡萄球菌583株(60.2%),金葡菌162株(16.7%),粪肠球菌28株(2.9%),大肠埃希菌21株(2.2%),屎肠球菌11株(1.1%),猪霍乱沙门菌猪霍乱亚种11株(1.1%).2006年MRSA的检出率为71.7%,产ESBLs大肠埃希菌的检出率为56.2%.2007年MRSA的检出率为79.6%,产ESBLs大肠埃希菌的检出率为47.6%.耐甲氧西林的葡萄球菌对常用抗生素的耐药率明显高于对甲氧西林敏感的葡萄球菌,未发现对万古霉素和替考拉宁耐药的葡萄球菌.结论 湖北地区三级医院儿科患者血培养检出的病原菌主要以葡萄球菌属为主,且存在严重的耐药问题.%Objective To investigate the distribution and antibiotic resistance of bacterial isolates from blood samples in pediatric patients in tertiary hospitals in Hubei area from 2006 to 2007.Methods Pathogenic bacteria isolated from blood samples of pediatric patients were collected from 17 tertiary hospitals in Hubei area from 2006 to 2007. All strains were isolated and identified by routine Methods . Antimicrobial susceptibility testing was conducted on all isolates using Kirby-Bauer Methods . Results A total of 941 strains were collected from January to December of 2006. The most common microorganism was coagulase-negative Staphylococcus (573, 60.9%), followed by Staphylococcus aureus (127, 13.5%), Enterococcus faecalis (33, 3.5%), Escherichia coli (16, 1.7%). A total of 969 strains were collected from January to December of 2007. The most common species was coagulase negative Staphylococcus (583, 60.2%), followed by S. aureus (162, 16.7%), E. faecalis (28, 2.9%), E. coli (21, 2.2%), E. faecium (11, 1.1%), Salmonella choleraesuis (11, 1.1%). Of the isolates collected during 2006, the prevalence of methicillin-resistant S. aureus (MRSA) was 71.7%. The prevalence of ESBLs was 56.2% in E. coli. Of the isolates collected during 2007, the prevalence of MRSA was 79.6%. The prevalence of ESBLs was 47.6% in E. coli. MRSA strains were more resistant to antibiotics than methicillin-susceptible S. aureus (MSSA). No glycopeptide-resistant strain was identified in Staphylococcus. Conclusions Staphylococcus is the most frequently isolated pathogen from blood samples of pediatric patients in tertiary hospitals in Hubei area.