小儿心脏术后下呼吸道感染常见病原菌分布及耐药性分析

Distribution and drug-resistance of common pathogens in children with lower respiratory tract infection after cardiac surgery

目的了解心血管病医院2006—2009年小儿心脏术后下呼吸道感染病原菌菌群分布及常见致病菌的耐药情况。方法病原菌采用Bio-Merieux VITEK32全自动微生物鉴定系统进行菌株鉴定及药敏试验。结果共分离出706株病原菌,最常见的革兰阴性杆菌是肺炎克雷伯菌(22.1%),铜绿假单胞菌(19.6%),其次是鲍曼不动杆菌(13.6%)、大肠埃希菌(12.2%)﹑阴沟肠杆菌(6.0%)及嗜麦芽寡养单胞菌(3.7%)。主要革兰阴性杆菌均对头孢哌酮/舒巴坦,哌拉西林/三唑巴坦,阿米卡星敏感,且除嗜麦芽寡养单胞菌外对亚胺培南和美罗培南也均敏感。大肠埃希菌,肺炎克雷伯菌产ESBLs菌株分别为88.4%及73.7%。结论小儿心脏术后下呼吸道感染的病原菌分布有其特殊性,了解其病原菌分布及耐药性,为临床感染治疗提供依据。

Objective To investigate drug-resistance of pathogens in children with lower respiratory tract infection after cardiac surgery in cardiovascular hospital from 2006 to2009. Methods Identification and antimicrobial susceptibility were determined by Vitek32. Results In the 706 isolated strains, the pathogens mainly consist of Gram-negative bacilli including K. pneumoniae（22.1% ）, P. aeruginosa （19.6%）, A.baumanii（13.6% ）, E. coli（12.2%）, E. cloacae（6.0%） and P maltophilia（3.7%）. The Gram-negative bacilli were sensitive to cefoperazone/ sulbactam, piperacillin/tazobactam and amikacin, all the Gram-negative bacilli except P. maltophilia were sensitive to imipem and mempem. The percentage of ESBLs produced by E. coli and K. pneumoniae is 88.4% and 73.7% respectively. Conclusion Due to its particularity, to study the pathogen and its drug-resistance in pediatrics patients with lower respiratory tract infection is very important for clinical treatment.