儿童下呼吸道感染常见病原菌分布及耐药性变迁

Changes of common pathogenic bacteria and their antimicrobial resistance in children with lower respiratory tract infection

目的：研究我院下呼吸道感染患儿病原菌分布及其耐药性变迁,为临床合理使用药物治疗提供参考依据.方法：对2008年1月到2010年12月住院的所有下呼吸道感染患儿,共907例,进行痰培养并对其鉴定和药敏结果进行回顾性分析.结果：3年中分离的革兰阴性杆菌以肺炎克雷伯菌（KPN）和大肠埃希菌（ECO）为主,KPN和ECO产超广谱β-内酰胺酶（ESBLs）率,分别达31.8%～40.0%和41.7%～54.1%;革兰阳性球菌以肺炎链球菌和金黄色葡萄球菌为主,其中耐甲氧西林金黄色葡萄球菌（MRSA）分离率达28.5%～54.4%.病原菌对大部分抗生素有耐药性.结论：儿童下呼吸道感染常见病原菌主要为革兰阴性杆菌,对头孢类耐药率较高,且有逐年升高趋势,故临床上应根据药敏结果合理使用抗生素.

Objective：To investigate changes of common pathogenic bacteria and their antimicrobial resistance in children with lower respiratory tract infeetion（LRTI）in our hospital. Methods： From January, 2008 to December, 2010, sputum Culture and their drug sensitivity tests from all children（907）with LRTI, who had been admitted to in the pediatric ward of our hospital, were retrospectively analyzed. Resuits：In recent three years, among the Gram-negative bacilli which in sputum culture, mainly Klebsiella pneumonia（KPN）and Escherichia Coli（ECO） ,and ESBLs producing KPN and ESBLs producing ECO accouted for 31.8%-40. 0% and 41.7% -54.1%. Among the Gram -positive cocci which in sputum culture, mainly Streptococcus pneumoniae and Staphylococcus Aureus, and Methicillin-resistant Staphylococcus Aureus accouted for 28.5 % ~ 54.4 %. Pathogenic bacteria were resistant to the majority of antibiotics. Conclusion：The common pathogenic bacteria in children with LRTI in our hospital are mainly Gramnegative bacilli. The high drug resistance rate of Cephalosporins showed increasing year by year. So antibiotics should be adopted reasonably base on drug sensitive test result.