Prabhu Kavitha, Bhat Sevitha, Rao Sunil
Department of Microbiology, Yenepoya Medical College, Deralakatte, Mangalore, India.
J Lab Physicians. 2010 Jul;2(2):85-8. doi: 10.4103/0974-2727.72156.
BACKGROUND / AIMS: Septicemia is one of the important causes of mortality and morbidity in neonates and children. Blood culture is the gold standard for the diagnosis. Emergence of multidrug resistant bacterial strains is a major problem in the management of sepsis. Present study was undertaken to identify the common bacterial pathogens associated with pediatric sepsis and to determine their antibiotic susceptibility pattern.
Blood cultures from 185 suspected cases of sepsis were examined. The growths from the subcultures were identified by conventional biochemical tests. Antibiotic susceptibility testing was performed by modified Kirby-Bauer disk diffusion method and drug resistant strains in primary screening were further processed for extended spectrum beta lactamases (ESBL) and methicillin resistant Staphylococcus aureus (MRSA) status by combination disk method (ESBL) and oxacillin disk diffusion method (MRSA).
Out of the 185 cultures obtained from suspected cases, 81 (44%) were culture positive. Fifty-two (35%) of the culture isolates were Gram negative bacilli. Twenty-eight (64%) of the isolates were Gram positive cocci. One case was of mixed infection. The prevalence of MRSA in 41 strains of S. aureus was found to be 29% (12 strains). The overall prevalence of ESBL producers among 28 Gram negative bacterial isolates was found to be 32% (9 strains).
This study stresses the need for the continuous screening and surveillance for antibiotic resistance in pediatric care unit.
背景/目的：败血症是新生儿和儿童死亡及发病的重要原因之一。血培养是诊断的金标准。多重耐药菌株的出现是败血症治疗中的一个主要问题。本研究旨在确定与儿童败血症相关的常见细菌病原体，并确定它们的抗生素敏感性模式。
对185例疑似败血症病例的血培养进行检查。通过传统生化试验鉴定亚培养物中的生长物。采用改良的 Kirby-Bauer 纸片扩散法进行抗生素敏感性试验，对初次筛选中的耐药菌株进一步通过联合纸片法（检测超广谱β-内酰胺酶）和苯唑西林纸片扩散法（检测耐甲氧西林金黄色葡萄球菌）检测超广谱β-内酰胺酶（ESBL）和耐甲氧西林金黄色葡萄球菌（MRSA）情况。
从疑似病例中获得的185份培养物中，81份（44%）培养阳性。培养分离物中52份（35%）为革兰阴性杆菌。28份（64%）分离物为革兰阳性球菌。1例为混合感染。在41株金黄色葡萄球菌中，MRSA的患病率为29%（12株）。在28株革兰阴性细菌分离物中，ESBL产生菌的总体患病率为32%（9株）。
本研究强调了在儿科护理病房持续进行抗生素耐药性筛查和监测的必要性。
