[1]王洁琳,周珍文,高飞,等.2014 ～ 2019 年广州地区血液肿瘤儿童血培养病原菌分布及耐药性特点分析[J].现代检验医学杂志,2020,35(05):82-86.[doi:10.3969/j.issn.1671-7414.2020.05.021]
　WANG Jie-lin,ZHOU Zhen-wen,GAO Fei,et al.Analysis on the Distribution and Characteristics of Drug Resistance of Pathogenic Bacteria in Blood Culture of Children with Blood Tumor in Guangzhou from 2014 to 2019[J].Journal of Modern Laboratory Medicine,2020,35(05):82-86.[doi:10.3969/j.issn.1671-7414.2020.05.021]
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2014 ～ 2019 年广州地区血液肿瘤儿童血培养病原菌分布及耐药性特点分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第35卷
期数:
2020年05期
页码:
82-86
栏目:
论著
出版日期:
2020-11-01

文章信息/Info

Title:
Analysis on the Distribution and Characteristics of Drug Resistance of Pathogenic Bacteria in Blood Culture of Children with Blood Tumor in Guangzhou from 2014 to 2019
文章编号:
1671-7414（2020）05-082-05
作者:
王洁琳; 周珍文; 高飞; 高秀蓉; 邓露露; 梁秉绍; 朱素菲
广州市妇女儿童医疗中心检验科，广州 510623
Author(s):
WANG Jie-lin; ZHOU Zhen-wen; GAO Fei; GAO Xiu-rong; DENG Lu-lu; LIANG Bing-shao; ZHU Su-fei
Department of Clinical Laboratory, Guangzhou Women and Children’s Medical Centre,Guangzhou 510623,China
关键词:
儿童; 血液肿瘤; 败血症; 耐药性
分类号:
R733；R730.43
DOI:
10.3969/j.issn.1671-7414.2020.05.021
文献标志码:
A
摘要:
目的　探讨本中心儿童血液肿瘤患者血培养病原菌的分布及耐药特点，为临床合理诊疗提供参考。方法　对 该中心2014 年~2019 年儿童血液肿瘤科室送检血培养样本所分离的病原菌以及药敏结果进行回顾性分析。结果　9 396 例患儿血培养标本共分离出病原菌538 株, 其中革兰阴性菌253 株（47.03%）、革兰阳性菌242 株（44.98%）、真菌 43 株（7.99%）。革兰阴性菌中以肺炎克雷伯菌（11.90%）、大肠埃希菌（10.04%）和铜绿假单胞菌（5.39%）为主， 三者对氨苄西林及一代头孢均表现出极高的耐药率，而厄他培南、美罗培南等碳青霉烯类抗生素对三种革兰阴性菌保持 了较好的抗菌活性。2014~2019 年肺炎克雷伯菌对氨苄西林/ 舒巴坦、头孢他啶、头孢吡肟、亚胺培南的耐药率差异有 统计学意义（χ2=11.328~15.203，P ＜ 0.05）。革兰氏阳性菌以凝固酶阴性葡萄球菌（17.47%）、缓症链球菌（10.60%） 和金黄色葡萄球菌（4.28%）为主；耐甲氧西林金黄色葡萄球菌分离率为30.80%，对青霉素G 的耐药率高达100%，但 对万古霉素、利奈唑胺及喹奴普汀均表现为敏感。真菌中热带假丝酵母菌（6.69%）占主要比例。结论　儿童血液肿瘤 患者感染的病原菌种类较多，多重耐药感染情况比较常见。明确病原菌种类及药敏结果，合理应用抗生素，对有效控制 血液感染有重要意义。
Abstract:
Objective　To explore the distribution and characteristics of drug resistance of bacteria in blood from children with hematologic tumor , so as to provide references for clinical selection of rational drug use and diagnosis and treatment. Methods　Retrospective analysis was conducted on the results of isolation and drug susceptibility from blood culture samples submitted for examination in the department of pediatric hematologic oncology from 2014 to 2019. Results　A total of 538 strains of pathogenic bacteria were isolated from blood culture samples of 9 396 children, among which 253 strains of Gramnegative bacilli (47.03%), 242 strains of Gram-positive cocci (44.98%) and 43 strains of fungi (7.80%) were isolated. Among the Gram-negative bacteria, Klebsiella pneumoniae (11.90%), Escherichia coli (10.04%) and Pseudomonas aeruginosa (5.39%) were mainly found, the three showed high drug resistance to ampicillin and cephalosporin. Carbapenems such as ertapenem and meropenem maintained good antibacterial activity against three gram-negative bacteria. The drug resistance rates of Klebsiella pneumoniae to ampicillin/sulbacillin, ceftazidine, cefepime and imipenem were statistically different from 2014 to 2019 (χ2=11.328~15.203，P< 0.05).The main Gram-positive bacteria were Coagulase negative Staphylococcus (17.47%), Bradycardia streptococcus strains (10.60%), and Staphylococcus aureus (4.28%) . The drug resistance rate of Methicillin-resistant golden grape ball strain was 30.80%, and the drug resistance rate of penicillin G was as high as 100%. However, it was sensitive to vancomycin, linezolidine and quinaputin. Among the fungi, Candida tropicalis (6.69%) accounted for the main proportion. Conclusion　There were many kinds of pathogenic bacteria in children with hematologic tumor, and multi-drug resistant infection was common. It is of great significance for the effective control of blood infection to clarify the types of pathogenic bacteria and the results of drug susceptibility, and to apply antibiotics rationally.

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备注/Memo

备注/Memo:
作者简介：王洁琳（1974?），女，学士，副主任技师，主要从事临床微生物检验工作，E-mail:1019402877@qq.com。
更新日期/Last Update: 2020-10-30