儿童呼吸道感染革兰阴性菌的分布及药敏分析

Antibiotic Resistance of Gram-negative Pathogens Isolated from Children with Respiratory Tract Infection

目的了解该地区儿科呼吸道感染革兰阴性菌分布和耐药情况。方法对2009年1～6月入住医院儿科420例呼吸道感染患儿的痰液标本，做菌株分离培养鉴定和药敏试验，并进行分析。结果分离培养出病原菌212株，检出率50．5％．其中革兰阴性菌148株，占69．8％，大肠埃希菌、肺炎克雷伯菌、流感嗜血菌、铜绿假单胞菌分别占33．1％、26．4％、13．5％和8．1％，占革兰阴性菌的前4位；大肠埃希菌和肺炎克雷伯菌对亚胺培南、头孢吡肟和庆大霉素等敏感；嗜血菌属对头孢噻肟、头孢呋辛、阿莫西林／克拉维酸、氯霉素、环丙沙星和亚胺培南等敏感．对复方新诺明、氨苄西林耐药率高；铜绿假单胞菌对多种抗菌药物耐药，对亚胺培南敏感。结论该地区儿童呼吸道感染以革兰阴性菌感染为主，其中大肠埃希菌、肺炎克雷伯菌、流感嗜血菌、铜绿假单胞菌的感染率较高，临床治疗应根据药敏指导合理使用抗菌药物。

OBJECTIVE To investigate the resistance and distribution of the Gram-negative pathogens isolated from children with respiratory tract infection in our distric. METHODS A total of 420 strains from sputum specimens of the sick children were isolated and cultured from Jan 2009 to Jun 2009, and the strains were identified and the antibiotic resistance tested. RESULTS There were 220 strains（50.5% ） including 148 （69.8%） of Gram-negative bacteria. The major Gram negative bacteria were Escherichia coli （33. 1%）, Klebsiella pneumoniae （26.4%）, Haernophilus in fluenzae （ 13.5% ） and Pseudomonas aeruginosa （8.1%）. From them E. coli and K. pneumoniae were sensitive to imipenem, cefepime and gentamicin, H. influenzae was sensitive to cefotaxime, cefuroxime, amoxicillin/clavulanic acid, chloramphenicol, ciprofloxacin and imipenem, but highly resistant to Cotrimoxazole and ampicillin and P. aeruginosa had a wide range of antibiotic resistance, but sensitive to imipenem. CONCLUSIONS The bacteria of respiratory tract infections in children in our district are mainly Gram-negatives. The major Gram-negative bacteria are E. coli, K. pneurnoniae, H. influenzae and P. aeruginosa. Clinical treatment should be chosen according to antimicrobial susceptibility test.