小儿下呼吸道感染病原菌分布及耐药性分析

Surveillance of Bacteria Distribution and Resistance to Antibiotics for Children's Low-respiratory Tract Infection

目的探讨本地区小儿下呼吸道感染病原菌分布及耐药情况。方法采用天地人微生物分析系统,对2008年1月至2010年5月在益阳市中心医院儿科治疗的下呼吸道感染患儿痰培养所分离的菌株进行鉴定分析。结果 2175份痰液中分离出病原菌698株(32.09%),其中革兰阴性杆菌490株(70.20%),主要为肺炎克雷伯菌145株(20.77%),大肠埃希菌138株(19.77%)和铜绿假单胞菌68株(9.46%);革兰阳性球菌158株(22.64%),主要为金黄色葡萄球菌54株(7.74%)和表皮葡萄球菌51株(7.31%);真菌50株(7.16%)。肺炎克雷伯菌与大肠埃希菌的超广谱β-内酰胺酶(ESBLs)的检出率分别为24.14%和21.74%;金黄色葡萄球菌中检出耐甲氧西林金葡菌(MRSA)占14.81%。美洛培南对革兰阴性杆菌具高度敏感性,未发现耐万古霉素的葡萄球菌。结论小儿下呼吸道感染的病原菌以革兰阴性杆菌为主,并呈多重耐药趋势,美洛培南对革兰阴性杆菌具良好敏感性,万古霉素对革兰阳性球菌具高度敏感性,临床应根据药敏试验结果合理选用抗生素。

Objective To investigate the bacterial distribution and resistance to antibiotica from low-respiratory tract infections of the hospitalized for this area use of antibiotics. Methods Sputum speciments for bacterial were collected in sterile tubes all of the children with LRTI bewteen January 2008 to May 2010 from the center hospital of Yiyang by ＂TIANDIREN＂ microbial identifi cation system. Results 2175 sputum of isolated pathogen 698 strains （32.09%）,including gram-negative bacteria 490 strains （70.20%）,mainly for pneumonia crayresearch bacteria 145 strains （20.77%）,escherichia coli 138 strains （19.77%） and pseudomonas aeruginosa 68 strains （9.46%）,Gram-positive staphylococcus 158strains （22.64%）,mainly for staphylococcus aureus 54 strains （7.74%） and staphylococcus epidermidis 51 strains （7.31%）,Fungi 50 strains （7.16%）. Pneumonia crayresearch with escherichia coli bacteria in the super broad-spectrum beta-lactamase ESBLs,24.14% and 21.74%,respectively. Staphylococcus aureus in methicillin-resistant （MRSA） 14.81%. The imine to gram-negative bacillus high sensitivity,that vancomycin resistance of staphylococcus aureus. Conclusions Children with lower respiratory pathogen gram-negative bacillus,and multiple resistance,and the trend of gram-negative bacillus good sensitivity to vancomycin,Gram-positive aureus high sensitivity,clinical should according to antimicrobial susceptibility test results proper chosing antibiotic.