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2015 - 2018年华东地区住院儿童血流感染的病原菌分布及其耐药性分析

Analysis of Pathogen Distribution and Its Antimicrobial Resistance in Bloodstream Infections in Hospitalized Children in East China, 2015-2018.

作者信息

Wang Cuicui, Hao Wei, Yu Ruihua, Wang Xiaokang, Zhang Jing, Wang Bo

机构信息

Medical Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China.

Pediatric Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, China.

出版信息

J Trop Pediatr. 2021 Jan 29;67(1). doi: 10.1093/tropej/fmaa077.

Abstract

This study analyzed the pathogen distribution in bloodstream-infected (BSI) children hospitalized in Shandong Province from 2015 to 2018, to identify prevention strategies and select empiric antimicrobial therapy for BSI in children. Blood sample data from 14 107 children from 162 hospitals of Shandong Province were obtained from the China Antimicrobial Resistance Surveillance System and analyzed with WHONET 5.6 software. The results of the blood culture test showed the growth of 70.6% Gram-positive and 29.4% Gram-negative bacteria. Of the 14 107 blood isolates, 59.3% were collected from males and 40.7% were from females. Coagulase-negative staphylococci (47.1%) were the most commonly distributed pathogens. The distribution of pathogens varied according to age group and season. All Staphylococcus isolates were susceptible to vancomycin, teicoplanin and linezolid. Clinically, significant declines in penicillin-resistant Streptococcus pneumonia and carbapenem-resistant Escherichia coli were observed during the study period; however, detection rates of carbapenem-resistant Klebsiella pneumoniae increased over time (p < 0.05). Empiric antimicrobial therapy should be prescribed according to corresponding regional pediatric antimicrobial-resistant data.

摘要

本研究分析了2015年至2018年在山东省住院的血流感染(BSI)儿童的病原体分布情况,以确定预防策略并为儿童BSI选择经验性抗菌治疗方案。从中国抗菌药物耐药监测系统获取了山东省162家医院14107名儿童的血样数据,并用WHONET 5.6软件进行分析。血培养检测结果显示,革兰氏阳性菌生长率为70.6%,革兰氏阴性菌为29.4%。在14107份血液分离株中,59.3%来自男性,40.7%来自女性。凝固酶阴性葡萄球菌(47.1%)是分布最广的病原体。病原体的分布因年龄组和季节而异。所有葡萄球菌分离株对万古霉素、替考拉宁和利奈唑胺敏感。临床上,在研究期间观察到耐青霉素肺炎链球菌和耐碳青霉烯类大肠杆菌显著减少;然而,耐碳青霉烯类肺炎克雷伯菌的检出率随时间增加(p<0.05)。应根据相应地区的儿科抗菌药物耐药数据开具经验性抗菌治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e1/7948388/41dbcaa720b4/fmaa077f1.jpg

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