儿童重症肺炎合并脓毒症病原菌及耐药性分析

Analysis of pathogenic bacteria and drug resistance of severe pneumonia complicated with sepsis in children

目的:分析重症肺炎合并脓毒症患儿的病原构成及耐药性,为合理用药提供依据。方法:分析118例儿童重症肺炎合并脓毒症临床资料,包括致病菌及药敏情况。结果:118例患儿中有73例(61.86%)检出病原菌,检出87株病原菌,革兰氏阴性(G^(-))菌49株(56.32%),革兰氏阳性(G^(+))菌24株(27.59%),真菌14株(16.09%);大肠埃希菌对氨苄西林、庆大霉素、复方新诺明、头孢曲松钠、妥布霉素的耐药率均在50%以上;肺炎链球菌对红霉素、复方新诺明、四环素的耐药率均在60%以上;金黄色葡萄球菌对青霉素耐药率达100%。结论:儿童重症肺炎合并脓毒症主要病原体为细菌,诊治时结合病原菌类别和药敏结果合理用药。

Objective:To analyze the pathogen composition and drug resistance in children with severe pneumonia complicated with sepsis,and to provide basis for rational drug use.Methods:The clinical data of 118 children with severe pneumonia complicated with sepsis are analyzed,including pathogenic bacteria and drug sensitivity.Results:Of the 118 children,pathogenic bacteriua were detected in 73 cases(61.86%),and 87 strains were found to be pathogenic bacteria,49(56.32%)strains were gram-negative(G^(-))bacteria,49(56.32%)strains were gram-positive(G^(+))bacteria,and 16(16.09%)strains were fungi;the drug resistance rate of escherichia coli to ampicillin,gentamicin,cotrimoxazole,ceftriaxone sodium,and tobramycin were above 50%;the drug resistance rate of streptococcus pneumoniae to erythromycin,cotrimoxazole and tetracycline were above 60%;and the resistance rate of staphylococcus aureus to penicillin reached 100%.Conclusion:Bacteria is the main pathogen for severe pneumonia complicated with sepsis in children,who should be treated rationally according to the type of pathogens and drug sensitivity test.