中国实验诊断学
中國實驗診斷學
중국실험진단학
CHINESE JOURNAL OF LABORATORY DIAGNOSIS
2015年
4期
590-592
,共3页
邹享珍%于梅芳%吕娟%蔡淑英%刘妙娥
鄒享珍%于梅芳%呂娟%蔡淑英%劉妙娥
추향진%우매방%려연%채숙영%류묘아
儿童肺炎%细菌感染%耐药%MRSA%ESBLs
兒童肺炎%細菌感染%耐藥%MRSA%ESBLs
인동폐염%세균감염%내약%MRSA%ESBLs
Children with pneumonia%Bacterial infection%Resistance%MRSA%ESBLs
目的:分析樟木头地区近年致儿童肺炎的细菌分布和耐药情况,以提高本地区对儿童细菌性肺炎的诊治水平,减少多重耐药菌的产生和流行。方法统计本院最近3年收治的儿童细菌性肺炎确诊病例,分析致儿童肺炎的细菌分布和耐药情况用于指导临床用药。结果最近3年本院共收治355例儿童细菌性肺炎确诊病例。其中,革兰氏阳性菌感染有54例,占总病例的15.2%(54/355),革兰氏阴性菌感染有301例,占总病例的84.8%(301/355)。在革兰氏阳性菌感染中,多重、双重、单重耐药分别为26、13、13例,仅2例无耐药,耐药率达96.3%(52/54);革兰氏阳性菌主要以葡萄球菌为主,占77.8%(42/54),检出 MRSA、MRS 菌共11例,占革兰氏阳性多重耐药菌的42.3%(11/26)。在革兰氏阴性菌感染中,多重、双重、单重耐药分别为132、34、128例,仅7例无耐药,耐药率达97.7%(294/301);革兰氏阴性菌主要以肺炎克雷伯菌(ECO)和大肠埃希菌(KPN)为主,占62.5%(188/301),检出产 ESBLs 菌36例,占革兰氏阴性多重耐药菌的27.3%(36/132),并且已出现亚胺培南耐药的 ECO 和 KPN。结论本地区致儿童肺炎的细菌耐药形式非常严峻,临床医生应加强细菌药敏检测和多重耐药菌监测,合理使用抗菌药物,减少多重耐药菌的产生。
目的:分析樟木頭地區近年緻兒童肺炎的細菌分佈和耐藥情況,以提高本地區對兒童細菌性肺炎的診治水平,減少多重耐藥菌的產生和流行。方法統計本院最近3年收治的兒童細菌性肺炎確診病例,分析緻兒童肺炎的細菌分佈和耐藥情況用于指導臨床用藥。結果最近3年本院共收治355例兒童細菌性肺炎確診病例。其中,革蘭氏暘性菌感染有54例,佔總病例的15.2%(54/355),革蘭氏陰性菌感染有301例,佔總病例的84.8%(301/355)。在革蘭氏暘性菌感染中,多重、雙重、單重耐藥分彆為26、13、13例,僅2例無耐藥,耐藥率達96.3%(52/54);革蘭氏暘性菌主要以葡萄毬菌為主,佔77.8%(42/54),檢齣 MRSA、MRS 菌共11例,佔革蘭氏暘性多重耐藥菌的42.3%(11/26)。在革蘭氏陰性菌感染中,多重、雙重、單重耐藥分彆為132、34、128例,僅7例無耐藥,耐藥率達97.7%(294/301);革蘭氏陰性菌主要以肺炎剋雷伯菌(ECO)和大腸埃希菌(KPN)為主,佔62.5%(188/301),檢齣產 ESBLs 菌36例,佔革蘭氏陰性多重耐藥菌的27.3%(36/132),併且已齣現亞胺培南耐藥的 ECO 和 KPN。結論本地區緻兒童肺炎的細菌耐藥形式非常嚴峻,臨床醫生應加彊細菌藥敏檢測和多重耐藥菌鑑測,閤理使用抗菌藥物,減少多重耐藥菌的產生。
목적:분석장목두지구근년치인동폐염적세균분포화내약정황,이제고본지구대인동세균성폐염적진치수평,감소다중내약균적산생화류행。방법통계본원최근3년수치적인동세균성폐염학진병례,분석치인동폐염적세균분포화내약정황용우지도림상용약。결과최근3년본원공수치355례인동세균성폐염학진병례。기중,혁란씨양성균감염유54례,점총병례적15.2%(54/355),혁란씨음성균감염유301례,점총병례적84.8%(301/355)。재혁란씨양성균감염중,다중、쌍중、단중내약분별위26、13、13례,부2례무내약,내약솔체96.3%(52/54);혁란씨양성균주요이포도구균위주,점77.8%(42/54),검출 MRSA、MRS 균공11례,점혁란씨양성다중내약균적42.3%(11/26)。재혁란씨음성균감염중,다중、쌍중、단중내약분별위132、34、128례,부7례무내약,내약솔체97.7%(294/301);혁란씨음성균주요이폐염극뢰백균(ECO)화대장애희균(KPN)위주,점62.5%(188/301),검출산 ESBLs 균36례,점혁란씨음성다중내약균적27.3%(36/132),병차이출현아알배남내약적 ECO 화 KPN。결론본지구치인동폐염적세균내약형식비상엄준,림상의생응가강세균약민검측화다중내약균감측,합리사용항균약물,감소다중내약균적산생。
Objective To analyze the bacterial distribution and drug resistance on children penumonia in zhang mu tou area in recent years with the aim of improving clinical diagnosis and reduce the spread of multi-drug resistance. Methods For the analysis of the bacterial distribution and drug resistance,Specimens were collected among 2012 to 2014 and the results were statisticed.Results A total of 355 patients were diagnosed in the past three years,among them 54 patients were Gram-positive infection (15.2%),301 patients Gram-negative infection (84.8%).The number of patients with Multi-drug resistance,double resistance and single resistance was 26,13 and 13 respectively in Gram-positive infection,and only 2 patients had no resistance,the resistance rate is 96.3%.There were 132,34 and 128 pa-tients with Multi-drug resistance,double resistance and single resistance in Gram-negative infection,just 7 no resist-ance,the resistance rate is 97.7%.The most common pathogens were Klebsiella pneumonia and Escherichia coli ,with the rate 62.5%.In Gram-negative infection,36 samples producing ESBLs accounted for the percentage of 27.3%, Klebsiella pneumonia and Escherichia coli resistance for imipenem had emergenced.Conclusion Drug resistance of children pneumonia is a serious problem in local area,it is important for clinical docters to enhance the diagnosis of multi-drug resistance and reduce the spread of multi-drug resistance.