儿童呼吸道感染病原菌分布及耐药性分析

Distribution and Drug Resistance of Pathogens in Respiratory Tract in Children

目的了解桂林地区呼吸道感染患儿咽部病原菌分布和抗菌药物耐药情况，以便有效指导临床合理用药。方法对住院呼吸道感染患儿的痰及咽拭子标本进行病原菌分离培养及鉴定，用K—B纸片扩散法进行药敏分析。结果检出病原菌733株，前3位病原菌分别为：流感嗜血菌165株（22．51％）、大肠埃希菌136株（18．55％）、酿脓链球菌51株（6．96％）；流感嗜血菌对复方新诺明耐药率59．39％，对氨苄西林耐药率36．36％，但对头孢菌素类，喹诺酮类药物的敏感率高，大肠埃希菌对亚胺培南、喹诺酮类及阿米卡星敏感率高，链球菌属对青霉素G、红霉素、克林霉素、复方新诺明耐药率高，分别达56．79％～69．63％。结论G菌上升为儿童呼吸道感染的主要致病菌，临床医师应根据近年病原菌谱变迁及药敏结果合理选用抗菌药物。

OBJECTIVE To investigate pathogenic bacteria isolated from children with respiratory tract infection （RTI） and bacterial resistance to commonly used antimicrobial agents in Guilin area, so as to instruct the rational use of antibiotics. METHODS Routine methods were used to isolate and identify bacteria species and samples of sputum or throat swabs were collected from children with respiratory infection in inpatient departments. The drug susceptibility tests were performed by Kirby-Bauer method. RESULTS Total 733 strains of bacteria were isolated. The Haemophilus influenzae（HI） was the most common （165 strains）, followed by Escherichia coli （136 strains） and Streptococcus pyogenes （51 strains）. The resistance of HI to trimetoprim-sulfa methoxazole and ampicillin was 59. 39% and 36.36%, respectively. Cephalosporins and quinolones were more sensitive to HI. Imipenem, quinolones and amikacin were more sensitive to E. coIi as yet. The resistant rate of Streptococcus to penicillin-G, erythromycin, clindamyein and trimetoprim-sulfa methoxazole was 56. 79-69. 63%. CONCLUSIONS Gram- negative bacilli are the main pathogenic bacteria in childrens respiratory tract infection. The drug resistance is conspicuous. Antibiotics for treating RTI should be selected based on pathogenic bacteria variance and the drug susceptibility test.