Abstract:

Objective    To investigate the distribution of positive strains in blood culture in children of different age with fever and drug resistance of the main bacterium. Methods    A total of 856 cases of fever children with positive strains from Shenzhen Children’s Hospital cultured from Jan.1，2011 to Dec.31，2013 were divided into five groups according to age： newborn， infants，younger children，preschool children （＞3～ 7 years old） and school-age to adolescence children （over 7 years）. Bacterial types of positive strains in different ages were analyzed，and drug sensitivity test results of common bacterial were summarized retrospectively. Results    The patients with positive blood culture were 856 cases（6.1%），and the total number of blood culture was 14，102 cases over the same period. Gram-positive bacteria were found in 643 cases， Gram-negative in 190，fungi and bacteria that could not be characterized in 23. The No.1 bacteria in different age groups were： coagulase-negative staphylococci （129，57.6%）in newborns group，coagulase-negative staphylococci （151，49.3%）in infant group，coagulase-negative staphylococci （89，47.1%）in younger child group，coagulase-negative staphylococci （45，48.9%）in preschool group，coagulase-negative staphylococci （20，88.9%） in school-age to adolescence children. Antibiotic susceptibility test results：methicillin resistant strains in staphylococcus spp（MRSA and MRCNS） accounted for 20.7% and 87.8%. Conclusion    The distribution of pathogens are different in different ages；antibiotics should be choosed based on pathogen distribution when there is no positive results of bacterial culture.

Key words: child, blood culture, pathogen, age

摘要：

目的    探讨不同年龄发热患儿血培养阳性菌株的分布及常见细菌耐药性。方法　收集深圳市儿童医院2011年1月1日至2013年12月31日血培养阳性的发热患儿856例，按其年龄分布分为5组：新生儿、婴儿、幼儿、学龄前期儿童（＞3～7岁）、学龄期至青春期儿童（＞7～14岁）。回顾性总结不同年龄段血培养阳性患儿的细菌排序，以及常见细菌的药物敏感试验结果。结果　共送检血培养14102例，阳性856例（6.1%）；其中革兰阳性菌（G+）643株，革兰阴性菌（G-）190株，真菌及不能定性的细菌23株。不同年龄组的第1位细菌均为凝固酶阴性的葡萄球菌：新生儿组为129株（57.6%）；婴儿组为151株（49.3%）；幼儿组为89株（47.1%）；学龄前期组为45株（48.9%）；学龄期至青春期组为20株（88.9%）。药敏试验结果：金黄色葡萄球菌和凝固酶阴性的葡萄球菌耐甲氧西林率为20.7%和87.8%。结论　不同年龄段的血培养菌株构成不同，经验性使用抗生素时需根据病原分布及耐药性合理选择。

关键词: 儿童, 血培养, 病原, 年龄