儿童医院多重耐药菌耐药情况分析(1)
摘 要：目的 了解本院多重耐药菌(MDROs)的分布情况及耐药情况，为本院医院感染控制和临床合理使用抗菌药物提供依据。方法 收集2015年1月～6月住院患儿细菌感染的临床分离菌株，依据2011年CLSL标准的常规鉴定和纸片扩散法，测定菌株对抗菌药物的敏感性，采用WHONET 5.5软件对收集到的细菌监测资料进行统计分析。结果 共检测出病原菌1330株，其中MDROs130株；检出前三位的MDROs为ESBLs阳性大肠埃希菌76株(58.50%)、耐甲氧西林金黄色葡萄球菌(MRSA)32株(24.60%)、ESBLs阳性克雷伯氏菌22株(16.90%)；检出MDROs前三位的科室依次是新生儿科、PICU、综合内科；MDR-GP对克林霉素、红霉素及β-内酰胺类抗菌药物耐药率较高，MDR-GN对头孢三代、常用抗革兰氏阴性菌的青霉素类抗菌药物耐药率较高。结论 本院MDROs的医院感染的防控重点在收治感染性疾病的内科。本院MDROs革兰氏阴性菌对红霉素、克林霉素，耐药率高于成人医院，儿童感染的MRSA的检出率低于成人医院，耐药率相似。
, 百拇医药 关键词：儿童医院；多重耐药菌；耐药率
中图分类号：R725.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.04.044
文章编号：1006-1959(2018)04-0125-03
Abstract：Objective To investigate the distribution and drug resistance of multidrug resistant bacteria (MDROs) in our hospital，for the hospital nosocomial infection control and clinical rational use of antimicrobial agents provide the basis.Methods The clinical isolates of bacterial infection of hospitalized children from January to June 2015 were collected.According to the routine identification of CLSL standard in 2011 and disk diffusion，the sensitivity of the strain to antimicrobial agents was determined.The collected data of bacterial surveillance were statistically analyzed by WHONET 5.5 software.Results A total of 1330 strains of pathogenic bacteria were detected，including MDROs 130 strains.The first three MDROs were ESBLs positive Escherichia coli 76 strains(58.50%)，Methicillin-resistant Staphylococcus aureus 32 strains (24.60%) were found to have 22 ESBLs-positive Klebsiella strains (16.90%).The first three departments of MDROs were pediatrics，PICU and integrated internal medicine.The resistance rate of MDR-GP to clindamycin， erythromycin and β -lactam antibiotics was higher than that of MDR-GN to the third generation of cephalosporins.Conclusion The prevention and control of nosocomial infection of MDROs in our hospital is focused on the internal medicine of infectious diseases.The resistance rate of MDROs gram-negative bacteria to erythromycin and clindamycin in our hospital is higher than that in adult hospital.The detection rate of MRSA in children was lower than that in adult hospitals， and the drug resistance rate was similar.
, 百拇医药
Key words：Children's hospital；Multidrug resistant bacteria；Drug resistance rate
隨着广谱抗菌药物的大量使用，特别是头孢三代、四代的广泛使用，细菌耐药的趋势越发突出[1]，虽然儿童医院MDROs的检出率低于成人医院[2]，但因为儿童用药的局限性，亦使在治疗MDROs感染的儿童上，对抗菌药物的使用顾虑重重，故对儿童医院MDROs的分布及耐药率进行分析，将数据提供给临床，对临床合理使用抗菌药物、减缓MDROs的出现具有重要的意义[3-4]，现将结果报道如下。
1资料与方法
1.1一般资料 资料来源于2015年1月～6月我院检验科细菌培养鉴定的MDROs，标本范围包括住院部所有科室的全部类型标本，同一患者同一部位多次检出的MDROs，记录为一株MDROs。, 百拇医药(李伟杰 陈丽琴 李亚玲)
, 百拇医药 关键词：儿童医院；多重耐药菌；耐药率
中图分类号：R725.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.04.044
文章编号：1006-1959(2018)04-0125-03
Abstract：Objective To investigate the distribution and drug resistance of multidrug resistant bacteria (MDROs) in our hospital，for the hospital nosocomial infection control and clinical rational use of antimicrobial agents provide the basis.Methods The clinical isolates of bacterial infection of hospitalized children from January to June 2015 were collected.According to the routine identification of CLSL standard in 2011 and disk diffusion，the sensitivity of the strain to antimicrobial agents was determined.The collected data of bacterial surveillance were statistically analyzed by WHONET 5.5 software.Results A total of 1330 strains of pathogenic bacteria were detected，including MDROs 130 strains.The first three MDROs were ESBLs positive Escherichia coli 76 strains(58.50%)，Methicillin-resistant Staphylococcus aureus 32 strains (24.60%) were found to have 22 ESBLs-positive Klebsiella strains (16.90%).The first three departments of MDROs were pediatrics，PICU and integrated internal medicine.The resistance rate of MDR-GP to clindamycin， erythromycin and β -lactam antibiotics was higher than that of MDR-GN to the third generation of cephalosporins.Conclusion The prevention and control of nosocomial infection of MDROs in our hospital is focused on the internal medicine of infectious diseases.The resistance rate of MDROs gram-negative bacteria to erythromycin and clindamycin in our hospital is higher than that in adult hospital.The detection rate of MRSA in children was lower than that in adult hospitals， and the drug resistance rate was similar.
, 百拇医药
Key words：Children's hospital；Multidrug resistant bacteria；Drug resistance rate
隨着广谱抗菌药物的大量使用，特别是头孢三代、四代的广泛使用，细菌耐药的趋势越发突出[1]，虽然儿童医院MDROs的检出率低于成人医院[2]，但因为儿童用药的局限性，亦使在治疗MDROs感染的儿童上，对抗菌药物的使用顾虑重重，故对儿童医院MDROs的分布及耐药率进行分析，将数据提供给临床，对临床合理使用抗菌药物、减缓MDROs的出现具有重要的意义[3-4]，现将结果报道如下。
1资料与方法
1.1一般资料 资料来源于2015年1月～6月我院检验科细菌培养鉴定的MDROs，标本范围包括住院部所有科室的全部类型标本，同一患者同一部位多次检出的MDROs，记录为一株MDROs。, 百拇医药(李伟杰 陈丽琴 李亚玲)