儿童软组织感染病原菌分布及其耐药性
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俞松

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R378

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Distribution and antimicrobial resistance of pathogens causing soft tissue infection in children
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    摘要:

    目的探讨儿童软组织感染(STI)病原菌及其耐药性。方法分析某院2010年1月—2017年1月收治的细菌培养阳性的STI患儿,并分为社区STI组和医院感染STI组,对STI病原菌及其耐药性进行分析。结果共收治165例细菌培养阳性的STI患儿。社区STI组98例,医院感染STI组67例。共培养出细菌16种。98例社区STI均为单细菌感染,其中革兰阳性(G+)菌92株,主要为金黄色葡萄球菌(85株,86.7%)、化脓性链球菌(4株,4.08%);革兰阴性(G-)菌6株,主要为大肠埃希菌(3株,3.06%)、肺炎克雷伯菌(2株,2.04%)。医院感染STI组67例,5例为两种细菌混合感染,共培养出细菌72株,G+菌13株,主要为金黄色葡萄球菌(9株,12.50%);G-菌59株,主要为大肠埃希菌(21株,29.17%)、铜绿假单胞菌(15株,20.83%)、阴沟肠杆菌(13株,18.06%)。金黄色葡萄球菌对青霉素、红霉素、林可霉素耐药率>50%,对庆大霉素、复方磺胺甲口恶唑和利福平的耐药率<20%,耐甲氧西林金黄色葡萄球菌的检出率为43.62%,未发现对万古霉素、利奈唑胺、替加环素、左氧氟沙星、莫西沙星和呋喃妥因耐药菌株。大肠埃希菌对头孢呋辛、复方磺胺甲口恶唑的耐药率>70%,对哌拉西林、头孢吡肟和左氧氟沙星的耐药率<30%,未见对亚胺培南耐药的大肠埃希菌及铜绿假单胞菌菌株。结论儿童社区STI病原菌以金黄色葡萄球菌为主;医院感染STI病原菌以大肠埃希菌、铜绿假单胞菌、阴沟肠杆菌等G-菌为主。儿童STI在未明确病原菌之前,可根据感染的类型选择相应的抗菌药物。

    Abstract:

    ObjectiveTo explore distribution and antimicrobial resistance of pathogens causing soft tissue infection (STI) in children. MethodsChildren with STI and had positive bacterial culture in a hospital between January 2010 and January 2017 were analyzed, they were divided into communityassociated STI group(CASTI) and healthcareassociated STI(HASTI) group, pathogens and antimicrobial resistance of pathogens causing STI were analyzed. ResultsA total of 165 STI patients were with positive bacterial culture. There were 98 cases in CASTI group and 67 in HASTI group. 16 kinds of bacteria were isolated. 98 cases of CASTI were single bacterial infection, 92 of which were grampositive bacteria, mainly Staphylococcus aureus (S. aureus, n=85, 86.7%) and Streptococcus pyogenes (n=4, 4.08%); 6 strains were gramnegative bacteria, mainly Escherichia coli(E. coli, n=3, 3.06%) and Klebsiella pneumoniae(n=2, 2.04%). 67 cases were HASTI, 5 cases were mixed infection with two kinds of bacteria, 72 strains of bacteria were isolated, 13 were grampositive bacteria strains, mainly S. aureus (n=9, 12.50%);59 were gramnegative bacteria, mainly E. coli (n=21, 29.17%), Pseudomonas aeruginosa (P. aeruginosa, n=15, 20.83%), and Enterobacter cloacae(E. cloacae, n=13, 18.06%). Resistance rates of S. aureus to penicillin, erythromycin, and lincomycin were all>50%,resistance rates to gentamicin, compound sulfamethoxazole, and rifampicin were all <20%,isolation rate of methicillinresistant S. aureus (MRSA) was 43.62%, strains were all sensitive to vancomycin, linezolid, tigecycline, levofloxacin, moxifloxacin, and nitrofurantoin. Resistance rates of E. coli to cefuroxime and sulfamethoxazole were all >70%,resistance rates to piperacillin, cefepime, and levofloxacin were all <30%, imipenemresistant E. coli and P. aeruginosa were not found. ConclusionS. aureus is the main pathogen causing CASTI in children; the main pathogens of HASTI are E. coli, P. aeruginosa, E. cloacae, and other gramnegative bacteria. Children with STI can choose antimicrobial agents according to types of infection before pathogens are identified.

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张天久,俞松,杨小红,等.儿童软组织感染病原菌分布及其耐药性[J]. 中国感染控制杂志,2018,17(5):436-439. DOI:10.3969/j. issn.1671-9638.2018.05.015.
ZHANG Tianjiu, YU Song, YANG Xiaohong, et al. Distribution and antimicrobial resistance of pathogens causing soft tissue infection in children[J]. Chin J Infect Control, 2018,17(5):436-439. DOI:10.3969/j. issn.1671-9638.2018.05.015.

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  • 收稿日期:2017-07-24
  • 最后修改日期:2017-09-25
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  • 在线发布日期: 2018-05-28
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