摘要
目的分析无锡某医院儿童感染患者分泌物培养标本中病原菌的分布及耐药特点,为临床经验性治疗提供参考策略。方法回顾性收集2019—2023年该院2743份儿童分泌物培养标本,采用WHONET 5.6软件及CLSI标准分析病原菌分布与药敏结果。结果标本阳性检出率为19.76%(542/2743),共分离病原菌561株,其中革兰阳性菌(G+菌)428株(76.29%)、革兰阴性菌(G-菌)114株(20.32%)、真菌19株(3.39%)。排名前五的病原菌依次为金黄色葡萄球菌(55.08%)、表皮葡萄球菌(9.80%)、大肠埃希菌(4.46%)、肺炎克雷伯菌(3.39%)和铜绿假单胞菌(2.85%)。药敏结果显示,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为31.1%;大肠埃希菌、肺炎克雷伯菌对多数抗菌药物耐药率低于全国监测水平(左氧氟沙星除外)。阳性患儿中,扁桃体/腺样体肥大占34.50%,新生儿脐炎、新生儿感染等占24.54%,此类患儿可经验性选用β-内酰胺类含酶抑制剂或第一、二代头孢菌素治疗。结论该院儿童分泌物培养病原菌以G+菌为主,临床应结合病原菌分布及耐药特点选择抗菌药物,以提高疗效并减少耐药性发生。
Objective To analyze the distribution and drug resistance characteristics of pathogenic bacteria in secretion culture specimens from children with infections in a hospital in Wuxi,so as to provide reference strategies for clinical empirical treatment.Methods A retrospective collection of 2743 pediatric secretion culture specimens from 2019 to 2023 was conducted in the hospital.WHONET 5.6 software and CLSI standards were used to analyze the distribution of pathogens and drug sensitivity results.Results The positive detection rate of specimens was 19.76%(542/2743),with a total of 561 strains of pathogenic bacteria isolated.Among them,there were 428 strains of Gram-positive bacteria(G+bacteria)(76.29%),114 strains of Gram-negative bacteria(G-bacteria)(20.32%),and 19 strains of fungi(3.39%).The top five pathogenic bacteria were Staphylococcus aureus(55.08%),Staphylococcus epidermidis(9.80%),Escherichia coli(4.46%),Klebsiella pneumoniae(3.39%),and Pseudomonas aeruginosa(2.85%).The drug sensitivity results showed that the detection rate of methicillin-resistant Staphylococcus aureus(MRSA)was 31.1%;the resistance rates of Escherichia coli and Klebsiella pneumoniae to most antimicrobial drugs were lower than the national monitoring level(except for levofloxacin).Among the positive cases,tonsillar/adenoidal hypertrophy accounted for 34.50%,and neonatal omphalitis,neonatal infection,etc.accounted for 24.54%.Such patients can be empirically treated withβ-lactamase inhibitors or first-and second-generation cephalosporins.Conclusion The pathogenic bacteria cultured from children's secretions in this hospital are mainly G+bacteria.In clinical practice,antibacterial drugs should be selected according to the distribution and drug resistance characteristics of pathogenic bacteria to improve the efficacy and reduce the occurrence of drug resistance.
作者
唐毅敏
朱烨
洪远
TANG Yimin;ZHU Ye;HONG Yuan(Department of Pharmacy,Affiliated Wuxi People's Hospital of Nanjing Medical University,Wuxi 214023,Jiangsu,China;Department of Clinical Laboratory,Affiliated Children's Hospital of Jiangnan University,Wuxi 214023,Jiangsu,China;Department of Pharmacy,Affiliated Children's Hospital of Jiangnan University,Wuxi 214023,Jiangsu,China)
出处
《右江医学》
2025年第9期804-809,共6页
Chinese Youjiang Medical Journal
基金
无锡市“双百”中青年医疗卫生拔尖人才(BJ2020087)。
关键词
分泌物培养
抗菌药物治疗
病原菌
儿童
耐药性
secretion culture
antibacterial drug therapy
pathogenic bacteria
children
drug resistance
作者简介
第一作者:唐毅敏,女,主管药师,研究方向:抗感染临床合理用药。E-mail:2894879881@qq.com。
