大肠埃希菌致儿童急性下呼吸道感染118例

Clinical Analysis on 118 Children with Acute Lower Respiratory Tract Infection Caused by Escherichia Coli

目的了解大肠埃希菌在儿童急性下呼吸道感染中的发生率、细菌耐药情况和临床特征。方法对2005年10月～2006年10月临床诊断为急性下呼吸道感染的住院患儿659例行痰培养,并用纸片扩散法行药敏试验。结果经痰培养确诊118例大肠埃希菌感染,检出率为17.99%。其中男90例,女28例。在检出的菌株中,产超广谱β-内酰胺酶(ESBLs)87株,占73.73%。药敏结果显示100%的菌株对亚胺培南、美洛培南敏感,对常用抗生素头孢噻肟、头孢曲松、头孢他啶、氨苄西林、哌拉西林的耐药性依次为78.81%、73.73%、73.73%、76.27%、78.81%。结论昆明地区大肠埃希菌产ESBLs的阳性率高,耐药性日趋严重,亚胺培南等碳青霉烯类可作为其治疗的首选。

Objective To understand the prevalence, drug resistance and clinical features of children with acute lower respiratory tract infection（ALRI） caused by escherichia coll. Methods From Oct. 2005 to Oct. 2006,659 patients with ALRI who were admitted to hospital were chosen and their nasopharyngeal secretions were obtained and cultured. K - B disc diffusion for antibiotic susceptibility were performed for these clinical isolates. Results Among 659 patients, 118 cases were isolated escherichia coli, the rate was 17.99% which had 90 boys and 28 girls. Eighty - seven of 118 E. coli strains were with extended - spectrum β - lactamase（ESBLs） ,the rate was 73.73%. All of strains were sensitive to imipenem. For ESBLs - producing strains, the ratio of resistance tocefotaxime, ceftriaxone, cefuroxime, ampicillin, piperacillin were 78.81% ,73.73% ,73.73% ,76.27% ,78.81% ,respectively. Conclusions The positive rate of ESBLs producing E coli in Kunming area is high and drug resistance is severe gradually. Imipenem can be the first selection for treatment on these infections.