儿童下呼吸道感染细菌分布及耐药性分析

Chicdren lower respitatory infection bacteria distribution and drug resistance analysis

目地了解本院儿童下呼吸道感染病原茸的分布及耐药情况，以指导临床舍理选用抗生素。方法将住院患儿的痰液、咽拭子进行细菌培养并鉴定，对培养阳性者应用K—B法进行药敏试验。结果送检标本467份，共分离出病原菌247株，阳性率为52．9％，其中以G-菌为主占68．4％，G＋菌占23．9％，真菌占7．7％。感染前5位的病原菌分别是大肠埃希氏菌、肺炎克雷伯氏菌、铜绿假单胞菌、金黄色葡萄球菌、真菌。药敏结果显示，G-菌对氨苄西林耐药率最高，肺炎克雷伯氏菌和大肠埃希氏菌产超广谱B内酰胺酶（ESBk）的比例较高，分别为53．2％和46．1％。G＋菌对大多数抗菌素耐药，对大环内酯类耐药率最高，金黄色葡萄球菌耐甲氧西林的分离率为29．2％。结论儿科下呼吸道感染病原菌主要为G-菌，且呈多重耐药性，G＋菌对大多数抗菌素耐药，临床应根据药敏结果，合理选用抗生素。

Objective To study the distribution and drug resistance of pathogenic bacteria from children with lower respiratory infections to guide the antibiocties application proporly, Methods After bacteria cultivation and identification in sputamentum and threat swab collected from children with lower respiratory infections, K- B is applied in drug sensitive test to positivity cb.ildren. Results Among the examined 467 samples,247 pathogenic bacteria are found, and the positive rate is 52.9% （G- bacteria 68.4%, G＋ bacteria 23.9% ,and epiphyte 7.7% ）. The five type bacteria in highest infection rate are colon bacillus, Klebsiella pneumonia, pseudomonas aeruginosa, staphylococcus aureus, and epiphytes. The drug sensitive test shows that G- bacteria are the most resistant to ampicillin, The proportion of β ultra - broad - spectrum β ESBLs is higher in Klebsiella pneumonia and colon bacillus - respectively 53.2% and 46.1% . G＋ bacteria are resistant to the most bacteriophages, and is most resistant to macrolides, separation rate of staphylococcus aureus and dimethoxy - phenecillin 29.2%. Conclusion The pathogenic bacteria causing children＇ s lower respiratory infections are mainly G- bacteria, and G ＋ bacteria are resistant to most bacteriophages. The results from drug sensitive test should be employed to guide the use of antibiotics.