CAJ | 학술논문

目的：了解我国2012年医院临床从儿童患者分离的细菌构成及其对抗菌药的耐药性。方法收集来自全国557家三级医院和232家二级医院儿童患者分离的细菌，用纸片法或自动化仪器进行药物敏感性试验。用2012年美国实验室标准化研究所标准进行判读，用WHONET5.6进行统计分析。结果2012年共分离出儿童菌株117353株，其中革兰阴性菌株69710株，占总量59.40％。在革兰阴性菌株中前3位分别是大肠埃希菌19204株、肺炎克雷伯菌15051株及非发酵革兰阴性菌11254株（鲍曼不动杆菌5701株，铜绿假单胞菌5553株），分别占27.5％，21.6％和16.1％。大肠埃希菌对头孢菌素类和青霉素类抗菌药物的耐药性比较严重，对碳青霉烯类抗菌药物和阿米卡星仍保持较高的敏感性。肺炎克雷伯菌对喹喏酮类药物有良好的敏感性，对亚胺培南、美罗培南及阿米卡星的耐药率分别为7.4％，3.1％和3.6％。阿米卡星和多黏菌素B对非发酵革兰阴性菌有很好的抗菌活性。结论我国儿童革兰阴性细菌来源以大肠埃希菌、肺炎克雷伯菌及非发酵菌为主，细菌的耐药性仍为严重，需要关注耐碳青霉烯类肠杆菌科细菌及多药耐药非发酵菌的情况，必须采取积极有效的措施加以控制。
목적：료해아국2012년의원림상종인동환자분리적세균구성급기대항균약적내약성。방법수집래자전국557가삼급의원화232가이급의원인동환자분리적세균，용지편법혹자동화의기진행약물민감성시험。용2012년미국실험실표준화연구소표준진행판독，용WHONET5.6진행통계분석。결과2012년공분리출인동균주117353주，기중혁란음성균주69710주，점총량59.40％。재혁란음성균주중전3위분별시대장애희균19204주、폐염극뢰백균15051주급비발효혁란음성균11254주（포만불동간균5701주，동록가단포균5553주），분별점27.5％，21.6％화16.1％。대장애희균대두포균소류화청매소류항균약물적내약성비교엄중，대탄청매희류항균약물화아미잡성잉보지교고적민감성。폐염극뢰백균대규야동류약물유량호적민감성，대아알배남、미라배남급아미잡성적내약솔분별위7.4％，3.1％화3.6％。아미잡성화다점균소B대비발효혁란음성균유흔호적항균활성。결론아국인동혁란음성세균래원이대장애희균、폐염극뢰백균급비발효균위주，세균적내약성잉위엄중，수요관주내탄청매희류장간균과세균급다약내약비발효균적정황，필수채취적겁유효적조시가이공제。
Objective To determine the bacterial distribution and drug resistance of the pathogens isolated from children in China so as to pro-vide a basis for guiding the clinical use of antibiotics, exploiting new drugs and controlling hospital infection.Methods The clinical isolates were collected from 557 tertiary hospitals and 232 second class hospitals, and antibiotic susceptibility test was carried out by means of K-B disk diffusion or automatic bacterial identifying system.The data was analyzed with WNONET 5.6 software by referring to CLSI 2012 breakpoints.Results A total of 117353 bacterial strains were isolated from children, which included 69710 (59.4%) strains of gram-negative bacteria.The top three of them were Escherichia coli ( 19204 strains, 27.5%) , Kleb-siella pneumonia (15051 strains, 21.6%) and non-fermenting bacteria (11254 strains, 16.1%).Escherichia coli were highly resistant to cepha-losporins and penicillin antibiotics, and remained at a high sensitivity to carbapenems antibiotics and amikacin.Quinolones antibiotics had a well sensitivity to Klebsiella pneumonia,the resistance rates of Klebsiella pneu-monia to imipenem, meropenem and amikacin were 7.4%, 3.1%and 3.6%.Amikacin and polymyxin B had favourable antimicrobial activity to non-fermenting bacteria.No strains of minocycline-resistant Pseudomonas aeruginosa and aztreonam – resistant Acinetobacter baumannii were detected.Conclusion The Escherichia coli, Klebsiella pneumonia and non -fermenting bacteria are still the predominant pathogens in children of China.Bacterial resistance situation is still serious, great attention should be paid to the carbapenem-resistant Enterbacteriaceae and multidrug -resistant non -fermenting bacteria, we must take more effective measures to control it.