论文部分内容阅读
目的通过对手足口病ICU患儿的痰细菌培养及药敏分析,为有效地控制危重手足口病患儿肺部感染提供依据。方法采集2011年6月至2012年3月手足口病区住院的重症手足口病患儿的痰液标本,进行细菌培养。分离的菌株利用珠海黑马DL-96型微生物鉴定药敏分析系统进行鉴定与药敏分析。结果共送检痰培养标本634份,检出致病菌134株,检出率21.1%。呼吸道菌群以革兰阴性杆菌为主,肠杆菌科细菌构成比最高,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的耐药率较低,敏感度较高;对不含β-内酰胺酶抑制剂的头孢类抗生素耐药率较高,并存在多重耐药菌。部分非发酵菌构成比较高,对亚胺培南的敏感率为65%左右,存在30%左右的耐药率;对喹诺酮类有较高的敏感度。另有一定比例的真菌对临床常用的抗菌药物有多重耐药性。因此,尽快进行痰培养及药敏分析有针对性地选用抗菌药物,对危重症手足口病患儿的联合治疗具有积极的作用。结论重症手足口病患儿因多种原因易合并呼吸道病原菌感染,除考虑病毒感染外,应进行呼吸道病原菌的培养与药敏分析,以有效诊治患儿。
Objective To provide basis for the effective control of pulmonary infection in critically ill children with hand-foot-mouth disease through sputum bacterial culture and drug susceptibility analysis in children with hand-foot-mouth disease (ICU). Methods Sputum specimens of severe hand-foot-mouth disease hospitalized in HFMD from June 2011 to March 2012 were collected for bacterial culture. The isolated strains were identified and susceptible to susceptibility analysis using the drug susceptibility analysis system identified by Zhuhai dark horse DL-96 microorganism. Results A total of 634 sputum samples were collected, 134 pathogenic bacteria were detected, the detection rate was 21.1%. Gram-negative bacilli were the main respiratory tract bacteria, and the Enterobacteriaceae had the highest constitutional ratio, the lower resistance rate to cefoperazone / sulbactam and piperacillin / tazobactam, and the higher sensitivity. Cephalosporin-resistant β-lactamase-containing antibiotics resistant rate is high, and there are multiple drug-resistant bacteria. Some non-fermenting bacteria constitute relatively high sensitivity to imipenem about 65%, there is about 30% of the resistance rate; Quinolones have a higher sensitivity. Another percentage of fungi commonly used in clinical antibacterial multi-drug resistance. Therefore, as soon as possible sputum culture and drug sensitivity analysis of targeted use of antimicrobial drugs, the treatment of critically ill hand-foot-mouth disease in children with a positive effect. Conclusion Severe hand-foot-mouth disease in children with multiple reasons easy to be infected with respiratory pathogens, in addition to consider the virus infection, respiratory pathogens should be cultured and susceptibility analysis to effectively diagnose and treat children.