作　　者： (周聪）; (刘亚隽）; (张慧）; (申春梅）; (胡娟）; (沈芳）;

机构地区： 上海市第五人民医院,上海200240

出　　处： 《中国消毒学杂志》 2017年第8期767-770,共4页

摘　　要： 目的探讨儿童和成人血流感染病原菌分布及耐药的差异,为临床合理使用抗菌药物提供依据。方法采集2014年1月-2016年10月儿童和成人患者的血培养标本,采用VITEK 2 compact进行细菌鉴定,采用纸片扩散法进行药敏试验,比较二者的差异。结果儿童血培养病原菌以革兰阳性菌为主(64.2%),依次为凝固酶阴性葡萄球菌(53.7%)、唐菖蒲伯克霍尔德菌(20.1%)和嗜麦芽窄食单胞菌(6.0%);成人血培养病原菌以革兰阴性菌为主(53.1%),依次为大肠埃希菌(26.8%)、凝固酶阴性葡萄球菌(22.3%)和肺炎克雷伯菌(9.5%),2组间病原菌构成比除粪肠球菌外,其他差异均有统计学意义。2组常见革兰阴性菌构成比和耐药率差异均较大,儿童组对左氧氟沙星、复方新诺明和米诺环素的耐药率均为0,成人组对亚胺培南及美罗培南耐药率最低,其次为阿米卡星和磷霉素。结论儿童和成人血培养病原菌分布和耐药性差异很大,临床用药应考虑这一点,为患者早期治疗提供依据。 Objective To investigate the difference of bacteria distribution and drug resistance causing bloodstream infection in children and adult patients,and to provide basis for rational use of antibiotics in clinic. Methods Blood culture specimens were collected from children and adults from January 2014 to October 2016,VITEK 2 compact was used to identify pathogenic bacteria,disc diffusion test was used to detect the antimicrobial sensitivity of pathogenic bacteria,comparing the differences between children and adults. Results Gram positive bacteria were the main pathogenic bacteria in blood culture of children,accounting for 64. 2%. The first three were coagulase-negative Staphylococcus（ 53. 7%）,Burkholderia gladioli（ 20. 1%）,Stenotrophomonas maltophilia（ 6%）. Gram negative bacteria were the main pathogenic bacteria in blood culture of adults,accounting for 53. 1%. The most common were Escherichia coli（ 26. 8%）,coagulase-negative Staphylococcus（ 22. 3%）,Klebsiella pneumoniae（ 9. 5%）. There were statistically significant differences in the constituent ratio of the pathogens except Enterococcus faecalis. The children group of Common Gram negative bacteria resistant to levofloxacin,cotrimoxazole,minocycline rate was 0,the adult group of Common Gram negative bacteria to imipenem and meropenem resistance rate was the lowest,followed by Amikacin and Fosfomycin. Conclusion The difference of distribution and drug resistance of pathogenic bacteria in children and adults are obvious,and the clinical use should be considered to provide the basis for the early treatment of patients.

关 键 词： 儿童 成人 血流感染 病原菌分布 耐药性分析