59例小儿社区获得性大肠埃希菌肺炎的药敏分析

Analysis of drug sensitivity of community-acquired escherichia coli pneumonia in 59 children

目的探讨小儿社区获得性大肠埃希菌肺炎的药敏情况，指导临床治疗。方法对本院2003年1月～2006年7月确诊的59例大肠埃希菌肺炎患儿进行回顾性分析。结果小儿社区获得性大肠埃希菌肺炎中，大肠埃希菌检出率在连续3年多的时间内呈逐年递增的趋势，2003年12．2％，2004年13．5％，2005年14．6％，2006年前7个月26．2％。多数菌株对泰能、丁胺卡那霉素、环丙沙星、哌拉西林／他唑巴坦敏感性高，对大多数β-内酰胺类抗生素普遍耐药。产超广谱p．内酰胺酶（ESBLs）菌33例。阳性率为55．9％。对青霉素类和头孢菌素类耐药率均高于非产酶菌（均P〈0．05）。结论小儿社区获得性大肠埃希菌肺炎呈上升趋势，产ESBLs菌阳性率高，对多种抗生素耐药，故应重视痰培养及药敏试验，根据药敏试验合理使用抗生素。

Objective To investigate the prevalence and drug resistant patterns of community-acquired Escherichia coli pneumonia in children, and to give clinical suggestions for treatment. Methods 59 samples of community-acquired Escherichia coli pneumonia in our hospital between January, 2003 and July 2005 were analyzed retrospectively, Results The prevalence of community-acquired Escheriehia coli pneumonia of children has kept rising over the past three years, with 12. 2 % in 2003, 13.5 % in 2004, 14. 6 % in 2005 and 26.2 % in 2006. The drug sensitivity test showed that Escherichia coli were sensitive to tienam, Amikacin, ciprofloxacin and Piperacillin/tazobacta, while they were resistant to β-lactam antibiotics. 33 （55, 9% ） strains produced extended-spectrum β-lactamase（ESBLs）. The resistant rate of ESBLs-producing strains to penicillins and cephalosporins was higher than that of non ESBLs-producing strains （ P 〈0.05, respectively）. Condutioas The prevalence of community-acquired Escherichia coli pneumonia tends to increase in children. It is very important to make sputum culture and use sensitive antibiotics in treatment according to drug sensitivity test.