小儿肺炎病原菌的分布及耐药性调查

Distribution and Antibiotics Resistance of Pathogens in Pediatric Patients with Pneumonia

目的了解医院小儿肺炎的病原菌分布和耐药情况。方法对598例小儿肺炎患儿痰标本进行培养及药敏试验。结果 598份标本中检出病原菌272株,分离率45.5%;其中革兰阴性杆菌201株(73.9%),以肺炎克雷伯菌和大肠埃希菌为主,肺炎克雷伯菌及大肠埃希菌中产超广谱β-内酰胺酶(ESBLs)检出率分别为52.9%、43.8%,对亚胺培南、美罗培南耐药性最低;革兰阳性球菌52株(19.1%),以金黄色葡萄球菌为主,对万古霉素和替考拉宁最敏感;真菌19株(7.0%)。结论小儿肺炎病原菌以革兰阴性菌为主,不同菌种对抗菌药物耐药性存在很大差异,及时掌握病原菌分布及药敏动态对临床合理使用抗菌药物有重要意义。

OBJECTIVE To explore distribution and drug resistance of pathogens isolated from children patients with pneumonia.METHODS The pathogenic bacteria isolated from sputum specimens of 598 children patients were identified and their drug resistance was analyzed.RESULTS Totally 272 isolates were detected in total 598 sputum specimens,including 201 strains of Gram-negative bacteria（73.9%）,52 strains of Gram-positive bacteria（19.1%） and 19 strains of fungi（7.0%）,and the isolating rate was 45.5%.Klebsiella pneumoniae and Escherichia coli were the main Gram-negative strains in which the detection rates of（extended-spectrum β-lactamases ESBLs） were 52.9% and 43.8%,respectively.The susceptibility of these isolates to imipenem and meropenem was the highest.Staphylococcus aureus was the main gram-positive bacterium and its highest susceptibility antibiotics were vancomycin and teicoplanin.CONCLUSION The Gram-negative bacteria are the main pathogens and different bacterial species show significant antibiotics resistance.As a result,analysis of distribution and drug resistance of pathogens is important for rational administration of antibiotics in clinic.