CAJ | 학술논문

目的：了解2012年住院患儿血培养中分离的病原菌分布及耐药状况，为血源性感染患儿的临床诊治与流行病学特征提供用药依据。方法回顾性分析该院导致血源性感染的663株病原菌分布及其抗菌药物耐药情况。结果6333份血培养标本分离出病原菌663株，阳性率10．5％；其中革兰阳性球菌404株占60．9％，包括凝固酶阴性葡萄球菌、金黄色葡萄球菌、肠球菌属；革兰阴性杆菌253株占38．2％，主要包括阴沟肠杆菌、铜绿假单胞菌、木糖氧化产碱杆菌、嗜麦芽窄食假单胞菌等；真菌6株占0．9％。药敏试验检出革兰阳性球菌对万古霉素、利奈唑胺敏感，对青霉素、红霉素、氨苄西林＞90％以上耐药；革兰阴性杆菌未发现耐亚胺培南菌株。结论儿童血液感染患者菌种较复杂，革兰阳性球菌是引起菌血症的主要病原菌，药敏结果提示检出菌株耐药性较强，因此需要根据血液感染细菌的分布特性和耐药性，选择敏感的抗生素治疗血源性感染患儿。
목적：료해2012년주원환인혈배양중분리적병원균분포급내약상황，위혈원성감염환인적림상진치여류행병학특정제공용약의거。방법회고성분석해원도치혈원성감염적663주병원균분포급기항균약물내약정황。결과6333빈혈배양표본분리출병원균663주，양성솔10．5％；기중혁란양성구균404주점60．9％，포괄응고매음성포도구균、금황색포도구균、장구균속；혁란음성간균253주점38．2％，주요포괄음구장간균、동록가단포균、목당양화산감간균、기맥아착식가단포균등；진균6주점0．9％。약민시험검출혁란양성구균대만고매소、리내서알민감，대청매소、홍매소、안변서림＞90％이상내약；혁란음성간균미발현내아알배남균주。결론인동혈액감염환자균충교복잡，혁란양성구균시인기균혈증적주요병원균，약민결과제시검출균주내약성교강，인차수요근거혈액감염세균적분포특성화내약성，선택민감적항생소치료혈원성감염환인。
Objective To analyze the distribution and resistance of pathogens in blood culture species,so as to examine the clinical and epidemiological features of nosocomial bloodstream infectious(BSIS)-caused Gram-positive pathogens species,which were found in An-hui Provincial Children’s Hospital from 1 Jan 2012 through 31 Dec 2012.Methods Distribution and resistance of 663 isolates were restropectively studied.Results Six hundred and sixty-three strains of pathogenic bacteria were separated from the specimens of 6333 blood culture samples in our hospital.The positive rate was 10.5%.Of these strains 404(60.9%)were Gram-positive bacteria,inclu-ding CONS,Staphylocosaureus,Enterococci,253(38.2%)were Gram-negtive bacteria,including E.cloacae,P.aeruginosa,A.xylosoxi-dans,S.maltophilia,and 6(0.9%)were fungus.Gram-positive bacillis was sensitive to Vancomyc and Linezolid.Compared with chil-dren patients with nosocomial bloodstream infection caused by other Gram-negative pathogens,90% resistant to ≥3 classes of amtimi-crobials and were considered to be multidrug resistant including anti-imipenem isolates.Conclusions The resurgence of gram-positive bacteria is the predominant cause of nosocomical infectious pathogens in children patients in our hospital.Many Gram-positive cocci are now resistant to commonly used antibiotics.Therefore,newer,more effective antimicrobial therapies are needed to treat bloodstream in-fections according to the distribution and resistant of BSIS.