成都部分地区儿童社区获得性肺炎细菌病原调查及耐药分析

Community acquired pneumonia(CAP) investigation of bacterial and analysis of drug resistance for the partially district children of Chengdu

目的通过对成都部分地区近2年社区获得性肺炎（community acquired pneumonia，CAP）住院患儿进行细菌病原调查及耐药分析，为本地区临床医师提供目标治疗的参考依据。方法对2007年1月～2008年12月间在四川省妇幼保健院住院的CAP患儿，采集痰标本进行细菌培养及药敏检测，并对结果进行统计分析。结果送检痰培养1164例。检出细菌551株（47．3％），其中革兰阴性（G^-）菌373株（67．7％），以G^-杆菌最多，且大肠埃希菌多见于小婴儿。主要G^-杆菌对常用G^-杆菌抗生素耐药性增加，对头孢吡肟、头孢哌酮舒巴坦等耐药率多〈30％，对亚胺培南敏感性高，革兰阳性（G^＋）球菌165株（29．9％），主要为金黄色葡萄球菌、肺炎链球菌，前者多见于〈6个月婴儿，后者对青霉素、大环内酯类抗生素耐药性上升，真菌6株（1．1％）。结论近两年本地区CAP住院患儿细菌检出率较高，且以G^-杆菌最多，主要病原菌耐药情况存在一定的变迁。

Objective To provide reference for the treatment for clinicians during the recent two years investigation of bacterial and drug resistance analysis of hospitalized children with community acquired pneumonia （CAP） in some areas of Cbengdu. Methods Selected 1164 CAP cases of hospitalized children in the Maternal and Child Health Hospital of Sichuan from January 2007 to December 2008,actualized sputum culture,test of drug sensitivity and statistical analysis. Results In the 1164 eases of sputum culture,bacteria was 551 ones,accounting for 47.3% , it included 373 ones of gramnegative （ G^- ） bacteria, accounting for 67.7%, the maximum was G^-bacilli, in which Escheriehia coli were particularly prevalent in infancy. The drug resistance of the main （ G^- ） bacilli increased for antibiotic resistance of normal （ G^- ） bacilli, to eefepime, eefoperazone sulbactam and the others, the drug resistance rate is normally less than 30%, Imipenem presented high sensitivity,gram-positive （G^＋） cocci was 165 ones, accounting for 29. 9%, which are mainly staphylococcus gold, streptococcus pneumonia, the former was particularly prevalent in the baby younger than 6 months, the latter drug resistance increased for penicillin and macrelides, fungi are 6 ones,accounting for 1.1%. Conclusion The dominant pathogen during the recent two years in this region for the hospitalized children with CAP is bacterial, G^-bacilli is the most kind ,and there are some changes for the drug resistance of the dominant bacteria.