[1]王 娟,李 凯,王勇兵,等.革兰阴性菌血流感染患儿临床特点及病原菌分布和耐药性分析[J].新乡医学院学报,2019,36(7):634-636.[doi:10.7683/xxyxyxb.2019.07.008]
 WANG Juan,LI Kai,WANG Yong-bing,et al.Clinical characteristics,pathogenic bacteria distribution and drug resistance of children with gram-negative bacterial bloodstream infection[J].Journal of Xinxiang Medical University,2019,36(7):634-636.[doi:10.7683/xxyxyxb.2019.07.008]
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革兰阴性菌血流感染患儿临床特点及病原菌分布和耐药性分析
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
36
期数:
2019年7
页码:
634-636
栏目:
临床研究
出版日期:
2019-07-05

文章信息/Info

Title:
Clinical characteristics,pathogenic bacteria distribution and drug resistance of children with gram-negative bacterial bloodstream infection
作者:
王 娟李 凯王勇兵张欢欢周 莉王 军
(驻马店市第一人民医院新生儿重症医学科,河南 驻马店 463000)
Author(s):
WANG JuanLI KaiWANG Yong-bingZHANG Huan-huanZHOU LiWANG Jun
(Department of Neonatal Critical Care Medicine,the First People′s Hospital of Zhumadian City,Zhumadian 463000,Henan Province,China)
关键词:
血流感染革兰阴性菌儿童病原菌耐药性药物敏感性试验
Keywords:
bloodstream infectiongram-negative bacteriachildrenpathogenic bacteriadrug resistancedrug sensitivity test
分类号:
R631
DOI:
10.7683/xxyxyxb.2019.07.008
文献标志码:
A
摘要:
目的 分析革兰阴性菌血流感染(BSI)患儿的临床特点、病原菌分布及耐药性。方法 选择2013年1月至2017年12月驻马店市第一人民医院收治的346例革兰阴性菌BSI患儿为研究对象,分析其临床特点、病原菌分布及耐药性。结果 346例革兰阴性菌BSI患儿中,年龄≤28 d者226例(65.32%),29 d至1岁者82例(23.70%);新生儿重症监护病房170例(49.13%),新生儿普通病房78例(22.54%);有基础疾病者170例(49.13%),接受过侵袭性操作者94例(27.17%);治愈276例(79.77%),好转50例(14.45%),未治愈放弃治疗12例(3.47%),死亡8例(2.31%)。346份血液标本中共分离出革兰阴性菌378株,病原菌位居前3位者分别为大肠埃希菌(41.27%)、肺炎克雷伯菌(29.63%)和铜绿假单胞菌(10.05%)。大肠埃希菌和肺炎克雷伯菌对氨苄西林、哌拉西林、左氧氟沙星均有较高的耐药率,对头孢哌酮、头孢西丁、阿米卡星、亚胺培南和美罗培南耐药率较低。结论 革兰阴性菌BSI好发于新生儿,多合并基础疾病,大肠埃希菌和肺炎克雷伯菌是其主要致病菌,临床经验性治疗应首选碳青霉烯类抗生素。
Abstract:
Objective To investigate the clinical characteristics,pathogenic bacteria distribution and drug resistance of children with gram-negative bacterial bloodstream infection (BSI).Methods A total of 346 children with Gram-negative bacterial BSI admitted to the First People′s Hospital of Zhumadian City from January 2013 to December 2017 were selected as the subjects,and the clinical characteristics,pathogenic bacteria distribution and drug resistance were analyzed.Results Among the 346 children with gram-negative bacterial BSI,226(65.32%) cases were younger than or equal to 28 days,82 (23.70%) cases were aged from 29 days to 1 year;170 (49.13%) cases were in neonatal intensive care unit,78 (22.54%) cases were in neonatal general ward;170 (49.13%) cases had basic diseases,94 (27.17%) cases received invasive operation;276 (79.77%) cases were cured,50 (14.45%) cases were improved,12 (3.47%) cases gave up treatment without cure,and 8 (2.31%) cases died.378 Gram-negative bacteria were isolated from the 346 specimens,the top three pathogenic bacteria were Escherichia coli (41.27%),Klebsiella pneumoniae (29.63%) and Pseudomonas aeruginosa (10.05%),respectively.Escherichia coli and Klebsiella pneumoniae had high resistance rate to ampicillin,piperacillin and levofloxacin;but they had low resistance rate to cefoperazone,cefoxitin,amikacin,imipenem and meropenem.Conclusion Gram-negative bacteria BSI is predisposed to neonates,and most of them are associated with basic diseases.Escherichia coli and Klebsiella pneumoniae are the main pathogenic bacteria.Carbapenems should be the first choice for clinical empirical treatment.

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更新日期/Last Update: 2019-07-05