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目的了解宁波市妇女儿童医院小儿重症监护病房(PICU)呼吸道病原菌的临床分布特点和耐药情况,为临床合理用药提供依据。方法对本院2013年1月1日-2015年12月31日PICU送检的痰液和咽拭子标本分离培养的病原菌,进行分析及药敏试验,菌株鉴定采用法国生物梅里埃公司的VITEK 2 Compact全自动微生物分析仪,药敏试验采用MIC法,用参考菌株做质量控制。结果共分离病原菌678株,总阳性率为13.9%;其中革兰阳性菌占16.1%,以金黄色葡萄球菌为主;革兰阴性菌占75.2%,以肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌和阴沟肠杆菌为主;真菌占8.7%。药敏结果显示,临床分离的革兰阴性菌对常用的抗菌药物广泛耐药;金黄色葡萄球菌中MRSA对青霉素类G的耐药率为100.0%。结论对本院PICU患儿呼吸道病原菌进行培养、鉴定及相应的药敏分析有助于指导临床合理使用抗菌药物,有效控制感染。
Objective To understand the clinical distribution characteristics and drug resistance of respiratory pathogens in pediatric intensive care unit (PICU) of Ningbo Women and Children’s Hospital and provide the basis for clinical rational drug use. Methods The pathogenic bacteria isolated from the samples of sputum and throat swabs from January 1, 2013 to December 31, 2015 in PICU were analyzed and drug susceptibility test. The strains were identified by VITEK 2 Compact automatic microbial analyzer, drug susceptibility testing using MIC method, with reference strains to do quality control. Results A total of 678 pathogens were isolated, the total positive rate was 13.9%. Among them, Gram-positive bacteria accounted for 16.1%, mainly Staphylococcus aureus; Gram-negative bacteria accounted for 75.2%, Klebsiella pneumoniae, Escherichia coli , Acinetobacter baumannii and Enterobacter cloacae; fungi accounted for 8.7%. Susceptibility results showed that the clinical isolates of Gram-negative bacteria were widely resistant to commonly used antimicrobial agents. The resistance rate of MRSA to penicillin G in S. aureus was 100.0%. Conclusion The culture and identification of respiratory pathogens in children with PICU in our hospital and the corresponding drug susceptibility analysis will help to guide the rational use of antibacterial drugs in clinical practice and effectively control the infection.