小儿社区获得性肺炎病原及其耐药性分析

Etiology and antimicrobial resistance of children with community-acquired pneumonia

目的探讨小儿社区获得性肺炎病原体构成及其耐药性,为临床治疗提供依据。方法对426例小儿肺炎患者进行痰及咽拭子培养。结果检出病原体阳性269例,阳性率为63.1%,其中细菌阳性149例,肺炎支原体阳性118例,真菌2例。主要细菌为肺炎链球菌(SP)58株,流感嗜血杆菌(HI)30株,副流感嗜血杆菌(HP)35株,卡他布兰汉菌(MC)11株。肺炎链球菌对红霉素、阿奇霉素、克林霉素及苯唑西林的耐药率分别高达86.2%、70.7%、67.2%和65.5%。肺炎支原体(MP)对阿奇霉素、克拉霉素的耐药率分别为55.9%、50.8%。β内酰胺酶阳性率达71.1%。结论小儿社区获得性肺炎细菌检出率略高于肺炎支原体,细菌、肺炎支原体对抗生素耐药问题严重。

[Objective] To investigate the etiology and antimicrobial resistance of children with community-acquired pneumonia. [Methods] Sputumn and nasopharyneal specimens were collected from 426 children with community-acquirred pneumonia, bacteria and mycoplasma pneumonia were separated by culture. [Results] Totally pathogens were determined in 269（63.1%） of 426 cases, including 149 strains of bacteria and 2 strains of fungi and 118 cases of mycoplasma pneumonia infection. The major isolated bacteria included 58 strains of streptococcus pneumoniae, 35 strains of haemophilus paraintluenzae, 30 strains of haemophilus influenzae, and 11 strains of branhamella catarrhalis. The resistant rates of SP to erythromycin and azithromycin and clindamycin and oxacillin were 86.2%, 70.7%, 67.2% and 65.5% respectively, The resistant of rates of MP to azithromycin and clarithromycin were 55.9% and 50.8% respectively. The positive rate of β-lactumase was 71.1%. [Conclusions] The ratio of bacteria was slightly higher than MP from the sputumn and nasopharyneal of children with community-acquired pneumonia, antibiotics resistance is very serious.