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印度班加罗尔一家三级护理医院对10岁以下儿童菌血症的细菌学特征及抗菌谱的研究。

A study on the bacteriological profile and antibiogram of bacteremia in children below 10 years in a tertiary care hospital in bangalore, India.

作者信息

Tiwari Devendra Kumar, Golia Saroj, K T Sangeetha, C L Vasudha

机构信息

Tutor, Dr. B.R Ambedkar Medical College , Bangalore, India .

Professor & HOD, Dr. B.R Ambedkar Medical College , Bangalore, India .

出版信息

J Clin Diagn Res. 2013 Dec;7(12):2732-5. doi: 10.7860/JCDR/2013/6682.3701. Epub 2013 Dec 15.

Abstract

INTRODUCTION

Blood stream infections are very common in the pediatric age group. Patients with bacteremia may have either a transient bacteremia that may be rapidly and permanently cleared by a patient's host defenses with no major consequences, or persistent bacteremia which can be self-limited without development of focal infection or sequelae, or may progress to a more serious fatal infection or toxic symptoms.

OBJECTIVES

The aim of our study is to analyze the hospital data on bacteremia in children less than 10 years with special reference to male and female cases, the pathogens involved, and the antibiotic susceptibility patterns.

METHODS

Over a one year period samples were collected from 128 children who included all newborn babies and children admitted with fever and suspected of having sepsis. Blood was collected depending upon age groups with aseptic precaution and incubated at 37(o)C for 10 days. Subcultures were made on blood agar and MacConkey agar plates. Organisms were identified and antibiotic sensitivity test of the isolates were performed.

RESULTS

Out of 128 suspected cases, 32 (25%) was culture positive. Male to female ratio is 1.28:1.0. Klebsiella species (43.75%) was the most common organism isolated followed by Staphylococcus aureus (18.75%). Prevalence of gram negative organism was 71.87%. Most of the gram negative organisms showed maximum resistance to ampicillin and the gram positive organisms to penicillin. In this study three gram negative organisms were extended-spectrum beta lactamases (ESBLs) producers and one Pseudomonas aeruginosa was metallo-beta lactamase (MBL) producer. 33.33% of staphylococcus aureus was Methicillin resistant Staphylococcus aureus (MRSA) strains.

INTERPRETATION AND CONCLUSION

This study showed a 25% prevalence rate of bacteremia among children with an increasing prevalence in the age group of 5-10 years and also an observed decline in susceptibility of the pathogens to common antibiotics which ultimately stresses on the need for continuous screening and surveillance for antibiotic resistance in the pediatric care unit and calls for increased efforts to ensure more rational use of these drugs.

摘要

引言

血流感染在儿童年龄组中非常常见。菌血症患者可能有短暂菌血症,可被患者的宿主防御迅速且永久清除,无重大后果;或持续性菌血症,可自限,不发生局灶性感染或后遗症,或可能进展为更严重的致命感染或毒性症状。

目的

我们研究的目的是分析10岁以下儿童菌血症的医院数据,特别参考男性和女性病例、所涉及的病原体以及抗生素敏感性模式。

方法

在一年期间,从128名儿童中采集样本,这些儿童包括所有新生儿以及因发热入院且怀疑患有败血症的儿童。根据年龄组采集血液,采取无菌预防措施,并在37℃下培养10天。在血琼脂和麦康凯琼脂平板上进行亚培养。鉴定微生物并对分离株进行抗生素敏感性试验。

结果

在128例疑似病例中,32例(25%)培养阳性。男女比例为1.28:1.0。克雷伯菌属(43.75%)是分离出的最常见微生物,其次是金黄色葡萄球菌(18.75%)。革兰氏阴性菌的患病率为71.87%。大多数革兰氏阴性菌对氨苄西林耐药性最高,革兰氏阳性菌对青霉素耐药性最高。在本研究中,三种革兰氏阴性菌是超广谱β-内酰胺酶(ESBLs)产生菌,一株铜绿假单胞菌是金属β-内酰胺酶(MBL)产生菌。33.33%的金黄色葡萄球菌是耐甲氧西林金黄色葡萄球菌(MRSA)菌株。

解读与结论

本研究显示儿童菌血症患病率为25%,在5 - 10岁年龄组患病率有所上升,且观察到病原体对常用抗生素的敏感性下降,这最终强调了在儿科护理单元持续进行抗生素耐药性筛查和监测的必要性,并呼吁加大努力确保更合理地使用这些药物。

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