摘要
目的 分析儿科院内感染特征、病原菌分布特点及感染危险因素。方法 选取247例儿科院内感染的患儿资料作为研究对象,回顾性分析患儿的病例资料,包括一般资料、医院感染资料及送检标本的病原菌鉴定结果。对被诊断为院内感染或可疑感染的患儿进行标本采集,接种于不同培养基进行培养分离后,采用全自动微生物鉴定仪进行病原菌鉴定。采用聚合酶链式反应对产超广谱β-内酰胺酶肺炎克雷伯菌进行扩增,通过扩增产物进行基因分型。结果 247例发生院内感染的患儿,共发生269例次感染。发生感染部位中,主要以呼吸道(上呼吸道98例次、下呼吸道57例次)与胃肠道(45例次)为主,其余依次为切口、泌尿系统、血液、皮肤、腹腔、其他部位。共检出病原菌275株,其中革兰阴性菌152株,革兰阳性菌56株,真菌25株,病毒42株。革兰阴性菌主要为肺炎克雷伯菌(29.45%)、大肠埃希菌(12.00%)、铜绿假单胞菌(6.55%)。革兰阳性菌主要为金黄色葡萄球菌(9.82%)与表皮葡萄球菌(4.36%)。真菌以白色念珠菌(5.82%)为主,病毒以轮状病毒(8.73%)为主。上呼吸道感染部位分离病原菌主要为肺炎克雷伯菌(36株)、大肠埃希菌(10株)及金黄色葡萄球菌(7株)。下呼吸道感染部位分离病原菌主要为肺炎克雷伯菌(19株)与大肠埃希菌(5株)。胃肠道感染部位分离病原菌主要为轮状病毒(22株)、大肠埃希菌(12株)与肺炎克雷伯菌(9株)。切口感染部位分离病原菌主要为金黄色葡萄球菌(12株)与表皮葡萄球菌(5株)。81株肺炎克雷伯菌中,产超广谱β-内酰胺酶肺炎克雷伯菌42株(51.85%)。对42株产超广谱β-内酰胺酶肺炎克雷伯菌进行PCR扩增,42株菌株引物扩增均呈阳性,主要为TEM型(10株)、CTX-M-1型(8株)及CTX-M-9型(7株)。对比247例发生院内感染患儿与同期80例未发生院内感染患儿的临床资料分析发现,年龄、营养状况、住院时�
Objective To analyze the distribution characteristics and risk factors of pathogenic bacteria in pediatric hospital infection. Methods The data of 247 children with nosocomial infection in the pediatric inpatient department of our hospital were selected as the research object, and the cases data of children were analyzed retrospectively, including general data, hospital infection data and pathogen identification results of the samples submitted for examination. The samples of children diagnosed as hospital infection or suspected infection were collected, inoculated in different culture media for culture and separation, and then the pathogens were identified by automatic microbial identification instrument. The ESBLs-producing Klebsiella pneumoniae was amplified and genotyped by the PCR. Results There were 269 cases of nosocomial infection in 247 children. The main infection sites were respiratory tract(98 cases of upper respiratory tract, 57 cases of lower respiratory tract) and gastrointestinal tract(45 cases of lower respiratory tract),and the rest were incision, urinary system, blood, skin, abdominal cavity and other sites in turn. 275 pathogens were detected, including 152 gram-negative bacteria, 56 gram-positive bacteria, 25 fungi and 42 viruses. Gram negative bacteria were mainly K. pneumoniae(29.45%),Escherichia coli(12.00%) and Pseudomonas aeruginosa(6.55%). The main Gram positive bacteria were Staphylococcus aureus(9.82%) and S. epidermidis(4.36%). Candida albicans(5.82%) was the main fungus and rotavirus(8.73%) was the main virus. The pathogenic bacteria isolated from the upper respiratory tract infection site were mainly K. pneumoniae(36 strains),E. coli(10 strains) and Staphylococcus aureus(7 strains). The pathogenic bacteria isolated from the lower respiratory tract infection site were mainly K. pneumoniae(19 strains) and E. coli(5 strains). The main pathogens isolated from the gastrointestinal tract infection site were rotavirus(22 strains),Escherichia coli(12 strains) and K. pneumoniae(9 strains).
作者
殷晓宁
贾维宁
YIN Xiao-ning;JIA Wei-ning(School of Nursing,Zhangjiakou University,Zhangjiakou 075000,Hebei,China)
出处
《中国病原生物学杂志》
CSCD
北大核心
2023年第2期229-232,237,共5页
Journal of Pathogen Biology
