Zhang Li, Wang Xiao-lei, Huang Cheng, Shen Wei, Liang Qin-jun, Li Xue-chun, Xie Yong-qiong, Deng Ke-fen, Li Jin-Shu, Wu Juan
Department of Laboratory Medicine, Chengdu Children's Hospital, Chengdu 610017, China.
Zhonghua Er Ke Za Zhi. 2007 Dec;45(12):927-31.
To investigate the variance and drug resistance of pathogenic bacteria isolated from children with infectious diseases seen between 2001 and 2006 in Chengdu area.
A total of 2888 pathogenic bacterial strains isolated from children in Chengdu Children's Hospital from 2001 to 2006 were analyzed. Tests were performed according to the guidelines of National Committee for Clinical Laboratory Standards (NCCLS) of the United States.
(1) Of the 2888 strains, 1845 (63.9%) were Gram negative bacteria. The main pathogenic bacteria included Escherichia coli (Ec, 718 strain, 24.9%), Hemophilus (H, 476 strain, 16.5%), Streptococcus pneumoniae (Sp, 412 strain, 14.3%), Klebsiella pneumoniae (Kp, 369 strain, 12.8%), Staphylococcus aureus (Sa, 353 strain, 12.2%), Staphylococcus epidermidis (Se, 278 strain, 9.6%), Pseudomonas aeruginosa (Pa, 146 strain, 5.1%) and other non-zymocyte (Onz, 136 strain, 4.7%). (2) The common pathogens found in blood specimen were 158 strain, which included Se (78 strain, 49.4%), Ec (23 strain, 14.6%), Kp (17 strain, 10.8%), Sa (14 strain, 8.9%), Onz (14 strain, 8.9%), Sp (7 strain, 4.4%) and Pa (5 strain, 3.2%). (3) The number of common pathogens isolated from patients with lower respiratory tract infection was 2018, including Ec (441 strains, 21.9%), H (430 strains, 21.3%), Sp (368 strains, 18.2%), Kp (253 strains, 12.5%), Sa (207 strains, 10.3%), Se (149 strains, 7.3%), Pa (97 strains, 4.8%) and Onz (73 strains, 3.6%). (4) There were 120 strains of common pathogens isolated from urine specimens, including Ec (78 strains, 65%), Kp (25 strains, 20.8%), Onz (7 strains, 5.8%), Pa (5 strains, 4.2%) and Se (5 strains, 4.2%). (5) There were 497 strains of common pathogens found in pus specimens, including Ec 167 strains, (33.6%), Sa (126 strains, 25.4%), Se (46 strains, 9.3%), H (44 strains, 8.9%), Onz (37 stains, 7.4%), Kp (31 strains, 6.2%), Sp (26 strains, 5.2%) and Pa (20 strain, 4.0%). The trend of drug resistance of pathogenic bacteria to antibiotics deteriorated. The proportion of methicillin-resistant Staphylococcus aureus (MRSA) was 6.7% and the methicillin-resistant coagulase-negative Staphylococci (MRCNS) rate was 20% in 2001 - 2003. The total proportion of extended-spectrum beta-lactamase stains (ESBL(S)) in Ec and Kp was 21.8%, and the rate of beta-lactamase production stains of Hemophilus influenzae (Hi) was 19.4% in 2001 - 2003.The proportion of MRSA was 17.2% and the MRCNS rate was 70.2%, the total proportion of ESBL(S) in Ec and Kp was 43.8%, and the rate of beta-lactamase producing stains of Hi was 39.7% in 2004 - 2006.
The distribution of common pathogenic bacteria seen in Chengdu Children's Hospital has changed and the trend of drug resistance of pathogenic bacteria to antibiotics deteriorated in recent three years. Regionally monitoring the changes in pathogenic bacteria and the trend of drug resistance to antibiotics is paramount in guiding the pediatric clinical treatment.
调查2001年至2006年成都地区传染病患儿分离出的病原菌的变化及耐药情况。
对2001年至2006年从成都儿童医院患儿中分离出的2888株病原菌进行分析。检测按照美国国家临床实验室标准委员会（NCCLS）的指南进行。
（1）2888株菌株中，1845株（63.9%）为革兰阴性菌。主要病原菌包括大肠埃希菌（Ec，718株，24.9%）、嗜血杆菌（H，476株，16.5%）、肺炎链球菌（Sp，412株，14.3%）、肺炎克雷伯菌（Kp，369株，12.8%）、金黄色葡萄球菌（Sa，353株，12.2%）、表皮葡萄球菌（Se，278株，9.6%）、铜绿假单胞菌（Pa，146株，5.1%）及其他非发酵菌（Onz，136株，4.7%）。（2）血液标本中常见病原菌158株，包括Se（78株，49.4%）、Ec（23株，14.6%）、Kp（17株，10.8%）、Sa（14株，8.9%）、Onz（14株，8.9%）、Sp（7株，4.4%）和Pa（5株，3.2%）。（3）下呼吸道感染患者分离出的常见病原菌2018株，包括Ec（441株，21.9%）、H（430株，21.3%）、Sp（368株，18.2%）、Kp（253株，12.5%）、Sa（207株，10.3%）、Se（149株，7.3%）、Pa（97株，4.8%）和Onz（73株，3.6%）。（4）尿液标本中分离出常见病原菌120株，包括Ec（78株，65%）、Kp（25株，20.8%）、Onz（7株，5.8%）、Pa（5株，4.2%）和Se（5株，4.2%）。（5）脓液标本中分离出常见病原菌497株，包括Ec 167株（33.6%）、Sa（126株，25.4%）、Se（46株，9.3%）、H（44株，8.9%）、Onz（37株，7.4%）、Kp（31株，6.2%）、Sp（26株，5.2%）和Pa（20株，4.0%）。病原菌对抗生素的耐药趋势恶化。2001 - 2003年耐甲氧西林金黄色葡萄球菌（MRSA）比例为6.7%，耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）率为20%。2001 - 2003年大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶菌株（ESBL(S)）总比例为21.8%，流感嗜血杆菌（Hi）产β-内酰胺酶菌株率为19.4%。2004 - 2006年MRSA比例为17.2%，MRCNS率为70.2%，大肠埃希菌和肺炎克雷伯菌中ESBL(S)总比例为43.8%，Hi产β-内酰胺酶菌株率为39.7%。
成都儿童医院常见病原菌分布发生变化，近三年病原菌对抗生素的耐药趋势恶化。对病原菌变化及抗生素耐药趋势进行区域监测对指导儿科临床治疗至关重要。
