Please wait a minute...
文章检索
预防医学  2025, Vol. 37 Issue (6): 616-621    DOI: 10.19485/j.cnki.issn2096-5087.2025.06.016
  疾病控制 本期目录 | 过刊浏览 | 高级检索 |
河北省某儿童医院住院患儿多重耐药菌耐药性分析
孙玲, 刘元青, 刘新光, 张楠, 温婵, 郝建宗, 李梅
河北省儿童医院,河北 石家庄 050031
Drug resistance of multidrug-resistant organism in hospitalized children at a children's hospital in Hebei Province
SUN Ling, LIU Yuanqing, LIU Xinguang, ZHANG Nan, WEN Chan, HAO Jianzong, LI Mei
Hebei Children's Hospital, Shijiazhuang, Hebei 050031, China
全文: PDF(871 KB)  
输出: BibTeX | EndNote (RIS)      
摘要 目的 分析2019—2023年河北省某儿童医院住院患儿多重耐药菌(MDRO)的耐药性,为临床合理应用抗菌药物治疗提供依据。方法 收集2019年1月1日—2023年12月31日河北省某儿童医院住院患儿痰液、血液、尿液、脓液、肺泡灌洗液、分泌物、胸腔液和腹腔液等样本送检,鉴定耐药菌;对耐甲氧西林金黄色葡萄球菌(MRSA)、产超广谱β-内酰胺酶大肠埃希菌(ESBLs-EC)、产超广谱β-内酰胺酶肺炎克雷伯菌(ESBLs-KP)、耐碳青霉烯类肺炎克雷伯菌(CRKP)、耐碳青霉烯类鲍曼不动杆菌(CRAB)、耐碳青霉烯类铜绿假单胞菌(CRPA)和耐碳青霉烯类大肠埃希菌(CREC)进行药敏试验;描述性分析MDRO的科室分布、样本来源分布和耐药性。结果 送检样本279 086份,检出MDRO 3 512株,其中MRSA和ESBLs-EC检出率较高,分别为35.76%和41.50%。内科患儿检出MDRO 1 869株,占53.22%,主要为呼吸科、新生儿科和重症医学科;外科1 643株,占46.78%,主要为普外科和心外科。痰液、脓液和尿液样本中检出MDRO较多,分别为1 372、527和494株,占39.07%、15.01%和14.07%。MRSA对青霉素、苯唑西林和红霉素耐药率为81.76%~100.00%,ESBLs-EC和ESBLs-KP对头孢曲松耐药率为100.00%,CRKP对氨苄西林/舒巴坦、亚胺培南耐药率均为100.00%,CRAB对头孢西丁、亚胺培南和美罗培南耐药率均为100.00%,CRPA对氨苄西林/舒巴坦、头孢曲松、头孢西丁和亚胺培南耐药率均为100.00%,CREC对亚胺培南耐药率为100.00%。结论 河北省某儿童医院住院患儿MDRO感染以MRSA和ESBLs-EC为主,主要分布在呼吸科、新生儿科、重症医学科、普外科和心外科,以痰液、脓液和尿液样本检出为主,MRSA、ESBLs-EC、ESBLs-KP、CRKP、CRAB、CRPA和CREC对多数抗菌药物耐药率较高。
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
孙玲
刘元青
刘新光
张楠
温婵
郝建宗
李梅
关键词 多重耐药菌儿童监测感染    
AbstractObjective To analyze the drug resistance of multidrug-resistant organism (MDRO) among hospitalized children in a children's hospital in Hebei Province from 2019 to 2023, so as to provide the basis for the rational clinical application of antibacterial drugs. Methods Specimens including sputum, blood, urine, pus, bronchoalveolar lavage fluid, secretions, pleural fluid, and peritoneal fluid of hospitalized children from January 2019 to December 2023 were collected. Pathogen identification and drug susceptibility tests were performed on methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum β-lactamase-producing Escherichia coli (ESBLs-EC), extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBLs-KP), carbapenem-resistant Klebsiella pneumoniae (CRKP), carbapenem-resistant Acinetobacter baumannii (CRAB), carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Escherichia coli (CREC). The department distribution, specimen distribution, and drug resistance of MDROs were analyzed. Results A total of 279 086 samples were submitted for testing, with 3 512 MDROs detected. Among these, MRSA and ESBLs-EC had relatively high detection rates of 35.76% and 41.50%, respectively. In the internal medicine pediatric patients, 1 869 MDROs were detected, accounting for 53.22%. The main departments were respiratory medicine, neonatology, and intensive care. In the surgical department, 1 643 MDROs were detected, accounting for 46.78%, with the main sources being general surgery and cardiac surgery. The highest numbers of MDROs were detected in sputum, pus, and urine samples, with 1 372, 527, and 494 isolates, representing 39.07%, 15.01%, and 14.07%, respectively. The resistance rates of MRSA to penicillin, oxacillin, and erythromycin were between 81.76% and 100.00%. ESBLs-EC and ESBLs-KP had a resistance rate of 100.00% to ceftriaxone. CRKP had a resistance rate of 100.00% to ampicillin/sulbactam and imipenem. CRAB had a resistance rate of 100.00% to cefoxitin, imipenem, and meropenem. CRPA had a resistance rate of 100.00% to ampicillin/sulbactam, ceftriaxone, cefoxitin, and imipenem. CREC had a resistance rate of 100.00% to imipenem. Conclusions In a children's hospital in Hebei Province, infections with MDROs among hospitalized pediatric patients are primarily caused by MRSA and ESBLs-EC. These infections are mainly distributed in the departments of respiratory medicine, neonatology, intensive care, general surgery, and cardiac surgery, with the highest detection rates in sputum, pus, and urine samples. Additionally, MRSA, ESBLs-EC, ESBLs-KP, CRKP, CRAB, CRPA, and CREC show high resistance rate to most antimicrobial agents.
Key wordsmultidrug-resistant organism    children    monitor    infect
收稿日期: 2024-12-23      修回日期: 2025-03-05      出版日期: 2025-06-10
中图分类号:  R179  
基金资助:河北省医学科学研究课题计划资助(20240237)
作者简介: 孙玲,博士,副主任医师,主要从事医院感染管理和传染病防控管理相关工作
通信作者: 李梅,E-mail:limeijulu@163.com   
引用本文:   
孙玲, 刘元青, 刘新光, 张楠, 温婵, 郝建宗, 李梅. 河北省某儿童医院住院患儿多重耐药菌耐药性分析[J]. 预防医学, 2025, 37(6): 616-621.
SUN Ling, LIU Yuanqing, LIU Xinguang, ZHANG Nan, WEN Chan, HAO Jianzong, LI Mei. Drug resistance of multidrug-resistant organism in hospitalized children at a children's hospital in Hebei Province. Preventive Medicine, 2025, 37(6): 616-621.
链接本文:  
http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2025.06.016      或      http://www.zjyfyxzz.com/CN/Y2025/V37/I6/616
[1] COLLABORATORS G A R.Global burden of bacterial antimicrobial resistance 1990-2021:a systematic analysis with forecasts to 2050[J].Lancet,2024,404(10459):1199-1226.
[2] 杨昊,刘长秀,李童.2018—2020年岳阳市儿童常见多重耐药菌感染及耐药性分析[J].甘肃医药,2023,42(10):897-899.
YANG H,LIU C X,LI T.Analysis of common multidrug-resistant bacterial infections and drug resistance in children in Yueyang City from 2018 to 2020[J].Gansu Med J,2023,42(10):897-899.(in Chinese)
[3] 张丽,孙雪荣,徐莉莉,等.2019—2021年住院儿童多重耐药菌分布及耐药性分析[J].青岛大学学报(医学版),2023,59(5):735-739.
ZHANG L,SUN X R,XU L L,et al.An analysis of distribution and drug resistance of multidrug-resistant organisms in hospitalized children from 2019 to 2021[J].J Qingdao Univ(Med Sci),2023,59(5):735-739.(in Chinese)
[4] 中华人民共和国国家卫生健康委员会.临床微生物学检验标本的采集和转运:WS/T 640—2018[S].2018.
National Health Commission of the People's Republic of China.Specimen collection and transport in clinical microbiology:WS/T 640—2018[S].2018.(in Chinese)
[5] 尚红,王毓三,申子瑜.全国临床检验操作规程(第四版)[M].北京:人民卫生出版社,2015.
SHANG H,WANG Y S,SHEN Z Y.National Clinical Laboratory Procedures (4th edition)[M].Beijing:People's Medical Publishing House,2015.(in Chinese)
[6] M100-S33 Clinical and Laboratory Standards Institute.Performance standards for antimicrobial susceptibility testing[S].2023.
[7] 中华人民共和国国家卫生健康委员会.医院感染监测标准:WS/T 312—2023[S].2023.
National Health Commission of the People's Republic of China.Hospital infection surveillance standards:WS/T 312—2023[S].2023.(in Chinese)
[8] 刘慧萍,王俊,高凯杰.2016—2020年某三甲儿童医院耐甲氧西林金黄色葡萄球菌分布及耐药性分析[J].实用预防医学,2022,29(8):1004-1007.
LIU H P,WANG J,GAO K J.Analysis of the distribution and drug resistance of methicillin-resistant Staphylococcus aureus in a tertiary children's hospital from 2016 to 2020[J].Pract Prev Med,2022,29(8):1004-1007.(in Chinese)
[9] 付盼,王传清,俞蕙,等.中国儿童细菌耐药监测组2023年儿童细菌耐药监测[J].中国循证儿科杂志,2024,19(4):272-280.
FU P,WANG C Q,YU H,et al.Antimicrobial resistance profile of clinical strains isolated from children in China:a report from the ISPED program 2023[J].Chin J Evid Based Pediatr,2024,19(4):272-280.(in Chinese)
[10] GUMUS D D,DEMIR O O,AYKAC K,et al.Gram-negative bacteremia,the risk factors,and outcome in children[J/OL].Diagn Microbiol Infect Dis,2024,109(3)[2025-03-05].https://doi.org/10.1016/j.diagmicrobio.2024.116324.
[11] BEDZICHOWSKA A,PRZEKORA J,STAPINSKA-SYNIEC A,et al.Frequency of infections caused by ESBL-producing bacteria in a pediatric ward-single-center five-year observation[J].Arch Med Sci,2019,15(3):688-693.
[12] 孙卫锋,吕锐,胡喜荣,等.老年住院脑卒中患者医院获得性肺炎病原菌分布及耐药性分析[J].预防医学,2021,33(12):1256-1259.
SUN W F,LYU R,HU X R,et al.Distribution and drug resistance of hospital-acquired pneumonia pathogens in elderly stroke patients[J].China Prev Med J,2021,33(12):1256-1259.(in Chinese)
[13] 何建春,裴昌贞,杨雷,等.近5年某院MRSA检出率、流行病学及耐药机制研究[J].国际检验医学杂志,2024,45(4):480-485.
HE J C,PEI C Z,YANG L,et al.Study on the detection rate,epidemiology and resistance mechanism of MRSA in a hospital in recent 5 years[J]. Int J Lab Med,2024,45(4):480-485.(in Chinese)
[14] 黄辉,魏佳,申汉俊,等.2017—2022年江苏省某儿童医院ICU患儿痰培养病原菌分布及耐药性变迁的分析[J].中华预防医学杂志,2024,58(10):1534-1540.
HUANG H,WEI J,SHEN H J,et al.Analysis of the changes of bacterial spectrum and drug resistance in sputum culture of ICU children in a hospital of pediatric in Jiangsu Province from 2017 to 2022[J].Chin J Prev Med,2024,58(10):1534-1540.(in Chinese)
[15] BRENNAN-KROHN T,MANETSCH R,O'DOHERTY G A,et al.New strategies and structural considerations in development of therapeutics for carbapenem-resistant Enterobacteriaceae[J].Transl Res,2020,220:14-32.
[16] WANG L X,GUO H,QU L Y,et al.Distribution and drug resistance of common pathogens causing lower respiratory tract infection in Xinjiang Region[J].Altern Ther Health Med,2024,30(11):399-403.
[17] VERKAIK N J,WIELDERS C,DEN BOER H,et al.Antimicrobial susceptibility to last-resort antibiotics in carbapenemase-producing bacteria from Ukrainian patients[J/OL].Microbiol Spectr,2024[2025-03-05].https://doi.org/10.1128/spectrum.01142-24.
[18] BIAN X C,LI M Y,LIU X F,et al.Transcriptomic investigations of polymyxins and colistin/sulbactam combination against carbapenem-resistant Acinetobacter baumannii[J].Comput Struct Biotechnol J,2024,23:2595-2605.
[19] SELIM H,GOMAA F,ALSHAHRANI M Y,et al.Colistin,doxycycline and Labetalol-meropenem combination are the most active against XDR-Carbapenem-resistant Acinetobacter baumannii:role of a novel transferrable plasmid conferring carbapenem resistance[J/OL].Diagn Microbiol Infect Dis,2024,110(4)[2025-03-05].https://doi.org/10.1016/j.diagmicrobio.2024.116558.
[20] 武文君,王炜,陈明心,等.某三甲中医院耐碳青霉烯类铜绿假单胞菌临床分离株耐药性和同源性[J].中华医院感染学杂志,2024,34(22):3376-3381.
WU W J,WANG W,CHEN M X,et al.Drug resistance and homology of clinical carbapenem-resistant Pseudomonas aeruginosa isolates from a three-a traditional Chinese medicine hospital[J].Chin J Nosocomio,2024,34(22):3376-3381.(in Chinese)
[1] 黄阳梅, 沈旭娟, 谢董颖, 张琦, 郑子聪, 王勐. 小学生体重监测信息反馈干预的效果评价[J]. 预防医学, 2025, 37(6): 541-545.
[2] 白茂潮, 李芬, 地力努尔·吐尔逊, 热米拉·热扎克, 王岩. HPV感染女性焦虑症状的影响因素分析[J]. 预防医学, 2025, 37(6): 573-577,582.
[3] 罗秀兰, 郑永韬, 倪梦姣, 鲁潮, 徐婷燕, 翁绩燕, 来芬华. 一起带状疱疹病例引起的医院水痘暴发疫情调查[J]. 预防医学, 2025, 37(5): 490-493.
[4] 白瑞盈, 生海燕. 肺炎住院患者多重耐药菌感染的预测模型研究[J]. 预防医学, 2025, 37(5): 465-470.
[5] 余红, 刘丹, 章逸莉, 陈晓霞. 绍兴市1岁儿童维生素D水平分析[J]. 预防医学, 2025, 37(4): 417-420.
[6] 王燕, 罗鹏. 湖州市某医院急性呼吸道感染病例常见病原体感染特征分析[J]. 预防医学, 2025, 37(3): 300-303.
[7] 王苓, 许珂, 张兴亮, 黄思超, 李西婷, 陈珺芳. 2022年杭州市新报告HIV/AIDS病例感染特征分析[J]. 预防医学, 2025, 37(2): 123-129.
[8] 陈溪, 杨泓生, 李炜, 翟睿, 姜妍琳, 王俊宏. 中国儿童孤独症谱系障碍影响因素的Meta分析[J]. 预防医学, 2025, 37(2): 181-188.
[9] 徐青华, 杨涛. 常山县血吸虫病综合治理策略及工作回顾[J]. 预防医学, 2025, 37(2): 212-216.
[10] 陈博, 王熙慧, 裘凤黔, 喻彦, 高淑娜, 何丽华, 李为翊, 纪云芳, 陈玮华. 0~3岁儿童安全座椅配备及使用情况调查[J]. 预防医学, 2025, 37(1): 21-25.
[11] 高帆, 王玉红, 顾一楠, 包旭艳, 徐秋叶. 近视儿童视觉训练效果评价[J]. 预防医学, 2024, 36(9): 776-780.
[12] 薛喆, 王思嘉, 卢兰兰, 王永, 龚清海, 沈鹏. 2011—2021年宁波市儿童青少年糖尿病发病趋势[J]. 预防医学, 2024, 36(9): 750-754.
[13] 李傅冬, 何凡, 何寒清, 章涛, 古雪, 俞敏. 2004—2020年浙江省10岁以下儿童乙型病毒性肝炎发病的年龄-时期-队列分析[J]. 预防医学, 2024, 36(9): 737-740.
[14] 吕阳, 乐博昕, 胡伟宏, 刘园, 陈昶, 刘效峰. 肺结核密切接触学生结核分枝杆菌潜伏感染的影响因素分析[J]. 预防医学, 2024, 36(8): 658-662.
[15] 夏林, 何建敏, 宁惊鸣, 李毅琳. 东西湖区学龄前儿童家长伤害急救技能调查[J]. 预防医学, 2024, 36(8): 718-722.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed