目的 分析南京醫(yī)科大學(xué)附屬兒童醫(yī)院兒外科重癥監(jiān)護(hù)病房（SICU）病原菌分布及耐藥率，為臨床合理選用抗菌藥物提供依據(jù)。方法 對(duì)2017年1月—2021年12月南京市兒童醫(yī)院SICU患兒送檢各類標(biāo)本所分離的病原菌及其耐藥狀況進(jìn)行回顧性分析。結(jié)果 11 939例標(biāo)本共分離出病原菌1 823株，分離率為15.27%。主要分離的革蘭陽(yáng)性菌有金黃色葡萄球菌、凝固酶陰性葡萄球菌；革蘭陰性菌有肺炎克雷伯菌、鮑曼不動(dòng)桿菌、大腸埃希菌、銅綠假單胞菌。金黃色葡萄球菌與凝固酶陰性葡萄球菌的甲氧西林耐藥率分別為42.46%、71.68%，未發(fā)現(xiàn)耐萬(wàn)古霉素菌株。革蘭陰性菌中，有71株肺炎克雷伯菌碳青霉烯耐藥菌株，耐藥率22.40%。結(jié)論 SICU科室應(yīng)根據(jù)患兒自身實(shí)際情況合理用藥、嚴(yán)格遵循無(wú)菌操作規(guī)范，監(jiān)測(cè)病原菌分布及耐藥狀況對(duì)抗菌藥物的合理選用有重要意義。

Objective The distribution and drug resistance rate of pathogenic bacteria in SICU of Children's Hospital of Nanjing Medical University were analyzed to provide basis for rational selection of antibacterial drugs in clinic. Methods Pathogens isolated from SICU children samples collected from Children's Hospital of Nanjing Medical University from January 2017 to December 2021, and their drug resistance were analyzed retrospectively. Results A total of 1 823 strains were isolated from 11 939 samples, with a separation rate of 15.27%. The main gram-positive bacteria were Staphylococcus aureus and coagulase negative staphylococcus. Gram-negative bacteria were Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, and Pseudomonas aeruginosa. Methicillin resistance rates of Staphylococcus aureus and coagulase negative staphylococcus were 42.46% and 71.68%, respectively, and no vancomycin-resistant strain was found. Among gram-negative bacteria, 71 strains of Klebsiella pneumoniae had carbapenem-resistant rate (22.40%). Conclusion s SICU department should use drugs rationally according to the actual situation of children, strictly follow the aseptic operation specifications, monitoring the distribution of pathogenic bacteria and drug resistance status is of great significance for the rational selection of antibacterial drugs.

R978.1

南京醫(yī)科大學(xué)科技發(fā)展基金項(xiàng)目(NMUB2019209)