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目的了解小儿败血症常见致病菌的抗菌药物敏感性及耐药情况。方法对血培养阳性的50例小儿败血症药物耐药性进行回顾性分析。结果培养的50株中金黄色葡萄球菌24株,肺炎球菌13株,表皮葡萄球菌6株,绿脓杆菌2株,肺炎杆菌2株,四联球菌2株,乙型链球菌1株。药敏结果显示:金黄色葡萄球菌对青霉素、氨苄青霉素、苯唑西林耐药率最高分别为95%、87.50%、83.33%,对金葡菌最敏感的是阿米卡星80%,其次为头孢唑林60%,头孢噻肟38.89%(中敏22.22%),头孢曲松22.73%(中敏36.36%)。对表皮葡萄球菌敏感的是阿米卡星100%,环丙沙星83.33%,头孢噻肟60%,头孢曲松和头孢唑林50%,青霉素100%耐药,氨苄西林与羧苄西林75%耐药。肺炎球菌对头孢噻肟、头孢曲松、青霉素耐药率较高,分别为70%、60%、60%。敏感的为阿米卡星40%(中敏50%)、庆大霉素62.50%、万古霉素42.80%(中敏50%)、氨苄青霉素42.86%(中敏14.28)。结论对临床诊断败血症的患儿血培养非常重要,能很好地指导临床,怀疑葡萄球菌感染时可首选头孢唑林、头孢曲松或头孢噻肟;怀疑肺炎球菌感染时可首选氨苄青霉素。
Objective To understand the antibacterial susceptibility and drug resistance of common pathogenic bacteria in pediatric sepsis. Methods Retrospective analysis of drug resistance in 50 pediatric septicemia patients positive for blood culture. Results Among the 50 strains of Staphylococcus aureus, 24 strains, 13 strains of pneumococcus, 6 strains of Staphylococcus epidermidis, 2 strains of Pseudomonas aeruginosa, 2 strains of Klebsiella pneumoniae, 2 strains of Tetragenococcus and 1 strain of Streptococcus. The results of drug susceptibility showed that the resistant rates of Staphylococcus aureus to penicillin, ampicillin and oxacillin were 95%, 87.50% and 83.33% respectively, the most sensitive to Staphylococcus aureus was amikacin 80%, followed by Cefazolin 60%, cefotaxime 38.89% (moderate 22.22%), ceftriaxone 22.73% (sensitive 36.36%). Staphylococcus epidermidis is sensitive to 100% amikacin, ciprofloxacin 83.33%, cefotaxime 60%, ceftriaxone and cefazolin 50%, 100% resistant to penicillin, ampicillin and carbenicillin 75 % Resistant. The resistant rates of pneumococci to cefotaxime, ceftriaxone and penicillin were higher, which were 70%, 60% and 60% respectively. Sensitive to 40% of amikacin (50% sensitive), gentamicin 62.50%, vancomycin 42.80% (50% sensitive), ampicillin 42.86% (sensitive 14.28). Conclusions Blood cultures of children with clinically diagnosed sepsis are very important and can guide the clinical practice. Cefazolin, ceftriaxone or cefotaxime may be the first choice for suspected staphylococcal infection. Ampicillin may be the first choice when pneumococcal infection is suspected.