湖北地区儿科患者血培养阳性病原菌的耐药性监测
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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 Sta phylococcus(573,60.9%).followed by Staphylococcus aureus(127.13.5%).Enterococcus faeculis(33,3.5%).Escherichia coli(16.1.7%).A total of 069 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.faeculis(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 ESHLs 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.
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 Sta phylococcus(573,60.9%).followed by Staphylococcus aureus(127.13.5%).Enterococcus faeculis(33,3.5%).Escherichia coli(16.1.7%).A total of 069 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.faeculis(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 ESHLs 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.
引文
[1]倪语星,尚红.临床微生物学与检验[M].第4版.北京:人民卫生出版社,2007:561.
[2]郭玉芬,甄景慧,张美和,等.北京儿童医院血培养检出菌17年的变迁与耐药性探讨[J].中华儿科杂志,2000,38(12): 750-754.
[3]徐亚萍,邵洁.浙江省儿童医院1991~2000年儿童败血症病原菌变迁及耐药分析[J].中华医学杂志,2002,82(14):945- 948.
[4]Raad I,Hanna HA,Alakech B,et al.Differential time to positivity: a useful method for diagnosing catheter-related bloodstream infections[J].Ann Intem Med,2004,140(1):18-25.
[5]Laupland KB,Gregson DB,Zygun DA,et al.Severe bloodstream infections:a population-based assessment[J].Crit Care Med,2004,32(4):992-997.
[6]徐雅萍,罗燕萍,周光,等.凝固酶阴性葡萄球菌所致血行感染的相关研究[J].中华医院感染学杂志,2006,16(2):224-226.
[7]孙自镛,陈静,朱旭慧,等.1998年~2006年血流感染病原菌及其耐药性分析[J].临床内科杂志,2007,24(11):736-740.
[8]徐修礼,刘家云.细菌对抗生素耐药机制研究的某些进展[J].国外医学临床生物化学与检验分册,2002,23(2):83-85.
[9]Tsakris A,Sofaanoous D,Legakis NJ.Alternative to vancomycin use for MRSA[J].APUA Newsletter,2002,20:1-3.
[10]邢铭友,田德英,刘莉娜,等.2004—2005年同济医院表皮葡萄球菌耐药性分析[J].华中科技大学学报(医学版),2007,36 (5):677-680.
[11]李家泰,李耘,齐慧敏.2002~2003年中国革兰阴性细菌耐药性监测研究[J].中华检验医学杂志,2005,28(1):19-29.
[12]张才仕,杨莲,刘平.大肠埃希菌产超广谱β-内酰胺酶耐药性监测[J].中华医院感染学杂志,2007,17(3):340-341.
[2]郭玉芬,甄景慧,张美和,等.北京儿童医院血培养检出菌17年的变迁与耐药性探讨[J].中华儿科杂志,2000,38(12): 750-754.
[3]徐亚萍,邵洁.浙江省儿童医院1991~2000年儿童败血症病原菌变迁及耐药分析[J].中华医学杂志,2002,82(14):945- 948.
[4]Raad I,Hanna HA,Alakech B,et al.Differential time to positivity: a useful method for diagnosing catheter-related bloodstream infections[J].Ann Intem Med,2004,140(1):18-25.
[5]Laupland KB,Gregson DB,Zygun DA,et al.Severe bloodstream infections:a population-based assessment[J].Crit Care Med,2004,32(4):992-997.
[6]徐雅萍,罗燕萍,周光,等.凝固酶阴性葡萄球菌所致血行感染的相关研究[J].中华医院感染学杂志,2006,16(2):224-226.
[7]孙自镛,陈静,朱旭慧,等.1998年~2006年血流感染病原菌及其耐药性分析[J].临床内科杂志,2007,24(11):736-740.
[8]徐修礼,刘家云.细菌对抗生素耐药机制研究的某些进展[J].国外医学临床生物化学与检验分册,2002,23(2):83-85.
[9]Tsakris A,Sofaanoous D,Legakis NJ.Alternative to vancomycin use for MRSA[J].APUA Newsletter,2002,20:1-3.
[10]邢铭友,田德英,刘莉娜,等.2004—2005年同济医院表皮葡萄球菌耐药性分析[J].华中科技大学学报(医学版),2007,36 (5):677-680.
[11]李家泰,李耘,齐慧敏.2002~2003年中国革兰阴性细菌耐药性监测研究[J].中华检验医学杂志,2005,28(1):19-29.
[12]张才仕,杨莲,刘平.大肠埃希菌产超广谱β-内酰胺酶耐药性监测[J].中华医院感染学杂志,2007,17(3):340-341.
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