中国实验诊断学
中國實驗診斷學
중국실험진단학
CHINESE JOURNAL OF LABORATORY DIAGNOSIS
2014年
5期
759-762
,共4页
革兰阴性杆菌%耐药性%儿童
革蘭陰性桿菌%耐藥性%兒童
혁란음성간균%내약성%인동
Gram-negative bacilli%drug resistance%children
目的:调查近3年我院住院和门诊患者的痰标本中分离的革兰阴性杆菌的菌群分布和耐药性。方法回顾性调查分析2008-2010年痰标本分离的革兰阴性菌株,所有菌株分离按《全国检验技术操作规程》第三版要求操作,采用 VITEK2 COMPACT 型全自动微生物分析仪进行细菌鉴定及药敏试验,并对结果进行统计分析。结果送检痰标本共21201份,检出致病菌8516株,检出率为40.17%,革兰阴性菌6345株,检出率为29.93%,其中肺炎克雷伯菌2198株,构成比为25.81%,大肠埃希菌1417株,构成比为16.64%,铜绿假单胞菌602株,构成比为7.07%。抗菌药物活性最高的是哌拉西林/他唑巴坦、丁胺卡那霉素(均达90%以上),碳青霉烯类、头孢替坦对大肠埃希菌、肺炎克雷伯菌敏感率均在90%以上,氨苄西林几乎对这三类细菌完全耐药,氨苄西林/舒巴坦、第一和第三代头胞菌素对大肠埃希菌、肺炎克雷伯菌敏感率较低;3年来 ESBLs 阳性率:大肠埃希菌分别为53.68%、49.09%、49.89%,肺炎克雷伯菌分别为49.19%、41.48%、38.80%。结论革兰阴性杆菌是深圳市儿童医院儿童痰标本分离的主要病原菌,其耐药情况并未出现较大的变迁,呈波动性变化。
目的:調查近3年我院住院和門診患者的痰標本中分離的革蘭陰性桿菌的菌群分佈和耐藥性。方法迴顧性調查分析2008-2010年痰標本分離的革蘭陰性菌株,所有菌株分離按《全國檢驗技術操作規程》第三版要求操作,採用 VITEK2 COMPACT 型全自動微生物分析儀進行細菌鑒定及藥敏試驗,併對結果進行統計分析。結果送檢痰標本共21201份,檢齣緻病菌8516株,檢齣率為40.17%,革蘭陰性菌6345株,檢齣率為29.93%,其中肺炎剋雷伯菌2198株,構成比為25.81%,大腸埃希菌1417株,構成比為16.64%,銅綠假單胞菌602株,構成比為7.07%。抗菌藥物活性最高的是哌拉西林/他唑巴坦、丁胺卡那黴素(均達90%以上),碳青黴烯類、頭孢替坦對大腸埃希菌、肺炎剋雷伯菌敏感率均在90%以上,氨芐西林幾乎對這三類細菌完全耐藥,氨芐西林/舒巴坦、第一和第三代頭胞菌素對大腸埃希菌、肺炎剋雷伯菌敏感率較低;3年來 ESBLs 暘性率:大腸埃希菌分彆為53.68%、49.09%、49.89%,肺炎剋雷伯菌分彆為49.19%、41.48%、38.80%。結論革蘭陰性桿菌是深圳市兒童醫院兒童痰標本分離的主要病原菌,其耐藥情況併未齣現較大的變遷,呈波動性變化。
목적:조사근3년아원주원화문진환자적담표본중분리적혁란음성간균적균군분포화내약성。방법회고성조사분석2008-2010년담표본분리적혁란음성균주,소유균주분리안《전국검험기술조작규정》제삼판요구조작,채용 VITEK2 COMPACT 형전자동미생물분석의진행세균감정급약민시험,병대결과진행통계분석。결과송검담표본공21201빈,검출치병균8516주,검출솔위40.17%,혁란음성균6345주,검출솔위29.93%,기중폐염극뢰백균2198주,구성비위25.81%,대장애희균1417주,구성비위16.64%,동록가단포균602주,구성비위7.07%。항균약물활성최고적시고랍서림/타서파탄、정알잡나매소(균체90%이상),탄청매희류、두포체탄대대장애희균、폐염극뢰백균민감솔균재90%이상,안변서림궤호대저삼류세균완전내약,안변서림/서파탄、제일화제삼대두포균소대대장애희균、폐염극뢰백균민감솔교저;3년래 ESBLs 양성솔:대장애희균분별위53.68%、49.09%、49.89%,폐염극뢰백균분별위49.19%、41.48%、38.80%。결론혁란음성간균시심수시인동의원인동담표본분리적주요병원균,기내약정황병미출현교대적변천,정파동성변화。
Objective To investigate the changes of pathogen distribution and their drug-resistance of gram-negative bacteria in children’s sputum culture in Shenzhen Children’s Hospital in recent 3 years.Methods A retrospective study on clinical distribution from sputum sample.VITEK2 automicroscan system was used to identify the species and conduct drug resistance test.The data was analyzed by WHONET5.4 software.Results A total of 8516 strains were i-solated from sputum sample(21201),with Gram-negative bacteria 6345(29.93%).The antibiotic remaining the most active against all of the gram-negative bacteria was piperacillin/tazobactam,amikacin(>90%).The susceptibility rate of Escherichina coli,Klebsiella pneumoniae to carbopenems and cefotetan above 90%.The three bacteria were almost antimicrobial resistance to ampicillin.The susceptibility rate of Escherichina coli,Klebsiella pneumoniae to ampicillin/sulbactam,the first and the third generation cephalosporins were low.The rate of ESBLs-producing to Escherichina coli was 53.68%,49.09%,49.89%,and to Klebsiella pneumoniae was 49.19%,41.48%,38.80% in the recent 3 years. Conclusion The main pathogenic bacteria from sputum sample is gram-negative bacteria in Shenzhen Children’s Hos-pital,and the drug resistance hadn’t been obviously vicissitudes.