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目的分析小儿心外科ICU患儿术后感染病原菌分布及耐药性,为临床合理选用抗菌药物提供依据。方法收集2014年1月-2015年11月小儿心外科ICU患儿送检的各类标本,分离出病原菌共221株,以美国BD公司的Phoenix100全自动细菌鉴定仪进行菌种鉴定和药敏试验,并对数据进行统计分析。结果共分离出221株病原菌,革兰阴性杆菌检出率为44.3%,以肺炎克雷伯菌和大肠埃希菌为主;革兰阳性球菌检出率为28.2%,以溶血性葡萄球菌和金黄色葡萄球菌为主;真菌检出率为26.7%,以白假丝酵母菌为主。肺炎克雷伯菌和大肠埃希菌对氨苄西林、阿莫西林/克拉维酸和氨苄西林/舒巴坦的耐药率较高。溶血性葡萄球菌对阿莫西林/克拉维酸全部耐药,金黄色葡萄球菌对青霉素和氨苄西林全部耐药。结论小儿心外科术后感染以革兰阴性杆菌为主,其次为革兰阳性菌与真菌,病原菌耐药形势严峻,应重视临床合理用药,预防控制院内感染。
Objective To analyze the distribution and drug resistance of pathogens in infants with ICU in pediatric cardiac surgery and provide basis for rational use of antimicrobial agents in clinic. Methods A total of 221 strains of pathogens were collected from children with ICU in pediatric cardiology department from January 2014 to November 2015. The strains were identified and susceptible tested by the Phoenix100 automatic bacterial analyzer from BD Company , And statistical analysis of the data. Results A total of 221 strains of pathogens were isolated. The detection rate of Gram-negative bacilli was 44.3%, mainly Klebsiella pneumoniae and Escherichia coli. The positive rate of Gram-positive cocci was 28.2% Staphylococcus aureus; fungi detection rate was 26.7%, mainly to Candida albicans. Klebsiella pneumoniae and Escherichia coli were more resistant to ampicillin, amoxicillin / clavulanic acid and ampicillin / sulbactam. Staphylococcus aureus amoxicillin / clavulanic acid resistance, Staphylococcus aureus penicillin and ampicillin full resistance. Conclusions The postoperative infection of pediatric cardiac surgery is mainly Gram-negative bacilli, followed by Gram-positive bacteria and fungi. The drug-resistant pathogen is in a severe situation. Clinical medication should be paid attention to to prevent and control nosocomial infections.