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目的探讨不同年龄发热患儿血培养阳性菌株的分布及常见细菌耐药性。方法收集深圳市儿童医院2011年1月1日至2013年12月31日血培养阳性的发热患儿856例,按其年龄分布分为5组:新生儿、婴儿、幼儿、学龄前期儿童(>3~7岁)、学龄期至青春期儿童(>7~14岁)。回顾性总结不同年龄段血培养阳性患儿的细菌排序,以及常见细菌的药物敏感试验结果。结果共送检血培养14102例,阳性856例(6.1%);其中革兰阳性菌(G~+)643株,革兰阴性菌(G~-)190株,真菌及不能定性的细菌23株。不同年龄组的第1位细菌均为凝固酶阴性的葡萄球菌:新生儿组为129株(57.6%);婴儿组为151株(49.3%);幼儿组为89株(47.1%);学龄前期组为45株(48.9%);学龄期至青春期组为20株(88.9%)。药敏试验结果:金黄色葡萄球菌和凝固酶阴性的葡萄球菌耐甲氧西林率为20.7%和87.8%。结论不同年龄段的血培养菌株构成不同,经验性使用抗生素时需根据病原分布及耐药性合理选择。
Objective To investigate the distribution of blood culture-positive strains of children with fever at different ages and common bacterial resistance. Methods A total of 856 cases of fever-positive children with blood culture were collected from Shenzhen Children’s Hospital from January 1, 2011 to December 31, 2013. According to their age distribution, they were divided into 5 groups: newborn, infant, toddler, preschool age> 3 to 7 years old), school-age to adolescent children (> 7 to 14 years old). We retrospectively summarized the bacterial sequencing of children with positive blood cultures at different ages and the results of drug sensitivity tests of common bacteria. Results A total of 14102 cases of blood culture were collected, of which 856 were positive (6.1%). There were 643 Gram-positive bacteria (G ~ +), 190 Gram-negative bacteria . The first bacterium in different age groups was coagulase-negative staphylococci: 129 newborns (57.6%), 151 (49.3%) infants, 89 (47.1%) infants, 45 (48.9%) were in the group and 20 (88.9%) in the school-age-adolescent group. Susceptibility test results: Staphylococcus aureus and coagulase-negative staphylococcus methicillin-resistant rates were 20.7% and 87.8%. Conclusions The blood culture strains of different ages have different constitutions, and the rational use of antibiotics should be based on the distribution of pathogens and resistance.