儿童呼吸道感染病原菌分布与耐药分析

Analysis on pathogenic distribution and drug resistance of respiratory tract infection in children

目的调查呼吸道感染患儿的主要病原菌及其对常用抗菌药物的耐药情况。方法采用苛养菌及链球菌鉴定的常规方法对呼吸道感染患儿的咽拭子标本进行分离、培养与鉴定。采用K-B纸片扩散法对分离出的病原菌进行药敏分析。结果286份咽拭子标本中共分离病原菌112株,检出率为39.16%。其中苛养菌72株,占病原菌的64.29%。流感嗜血杆菌对克拉霉素(70.01%)、复方磺胺甲口恶唑(60.00%)、氨苄西林(66.68%)耐药率高;肺炎链球菌对四环素(96.15%)、克林霉素(92.31%)、复方磺胺甲口恶唑(92.31%)、阿奇霉素(92.31%)耐药率高;化脓性链球菌对四环素(100.00%)、克林霉素(94.45%)、阿奇霉素(83.33%)耐药率高。结论苛养菌和化脓性球菌是引起儿童呼吸道感染的主要病原菌,治疗时应根据药敏结果合理选用抗菌药物。

Objective To investigate pathogenic bacteria isolated from children with respiratory tract infection and bacterial resistance to commonly used antimicrobial agents. Methods Routine methods were used to isolate and identify fastidous bacteria and Streptococcus from samples of children＇s throat swabs. The drug susceptibility tests were performed by Kirby-Bauer method. Results One hundred and twelve pathogenic bacteria were isolated from 286 samples. The isolation rate was 39. 16%, fastidous bacteria were 72 strains（64. 29%）. The resistant rate of Haemophilus influenzae to clarithromycin, trimethoprim-sulfamethoxazole and ampicllin was 70. 01%, 60. 00% and 66. 68% respectively; the resistant rate of Streptococcus pneumoniae to tetracycline, clindamycin, trimethoprimsulfamethoxazole and azithromycin was 96. 15%, 92. 31% ,92. 31% and 92. 13% respectively; the resistant rate of Streptococcus pyogenes to tetracycline, clindamycin and azithromycin was 100. 00 %, 94. 45 % and 83. 33 % respectively. Conclusion Fastidous bacteria and Streptococcus pyogenes are the main pathogenic bacteria in childrens＇ respiratory tract infection, antimicrobial agents should be chosen according to antimicrobial susceptibility test results.