小儿肺炎主要病原菌及药敏分析

目的:了解我院小儿肺炎住院病人病原菌分布情况及耐药性,以指导临床合理用药。方法:对2478例小儿肺炎患者的痰液标本进行培养、鉴定及药敏实验。结果:2478例痰液标本中分离到病原菌718株,其中革兰阳性菌139株,占19.4%,革兰阴性菌573株,占79.8%。检出的主要革兰阴性菌为大肠埃希菌、肺炎克雷伯菌、流感嗜血杆菌、鲍曼不动杆菌及铜绿假单胞菌,药敏实验显示它们对亚胺培南敏感度极高,对氨基糖苷类及喹诺酮类敏感度较高,对哌拉西林/他唑巴坦及替卡西林/克拉维酸相对较敏感,但对较常用的头孢菌素有较高的耐药性。结论:我院所属地区小儿肺炎病原菌以革兰阴性菌为主,临床上应加强病原菌的筛查及耐药性监测,合理使用抗菌药物。

Objective：To understand pathogens distribution and drug resistance of inpatients with infantile pneumonia in our hospital in order to guide reasonable clinical medication. Methods：The sputum samples of 2478 patients with infantile pneumonia were collected and bacteria cultured, distinguished and done experiments of drug susceptibility. Results ：718 strains of pathogens were isolated from the clinical sputum samples, among which 139 strains were gram positive （19.4%） ,573 strains were gram negative （79.8 % ）. The most common gram negative bacilli were Eseheriehia eoli, Klebsiella pneumonia, Hemophilus influenza, Aeinetobaeter baumannii and Pseudomonas aeruginosa. The experiments of drug sensitivity showed lmipenem has the highest susceptibility,quinlone and aminoglyeoside have higher susceptibility,and piperacillin/sulbactam and ticarcillin/clavulanieacid have susceptibility, but they showed highly tolerance to cephalosporln which is commonly used drug. Conclusion： The main pathogens of infantile pneumonia were gram negative bacilli in our hospital of the area. We should strengthen the screening of pathogens and antibiotic resistante in order to use antibiotics rationally.