儿童下呼吸道感染的病原菌及其耐药性分析

Pathogenic Bacteria Detection and Their Drug-resistance in Child Patients with Lower Respiratory Tract Infection

目的分析本院儿科病房下呼吸道感染患儿的致病菌及其耐药情况,为临床合理用药提供依据。方法标本经分离培养,做菌株鉴定和药敏试验。结果在1 015份痰标本中,共分离病原菌355株,阳性率34.98%。其中革兰阴性菌247株,主要为肺炎克雷伯菌(106株)和大肠埃希菌(72株),28.30%的肺炎克雷伯菌和47.22%的大肠埃希菌产超广谱β-内酰胺酶;革兰阳性菌92株,主要为金黄色葡萄球菌(62株),金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌的分离率为25.80%。致病菌对大部分抗生素有耐药性。结论本院儿科下呼吸道感染病原菌主要为革兰阴性菌,且呈多重耐药性,临床应根据药敏结果合理选用抗生素,以减少耐药菌株的出现。

Objective To analyze distribution and drug resistance pattern of pathogenic bacteria isolated from children with lower respiratory tract infection（LRTI） in our hospital,to provide a basis for clinical rational drug use.Methods Pathogenic bacteria were separated from sputum specimens of LRTI children to culture to perform strain identification and drug sensitive test.Results Three hundred fifty-five of 1 015 strains of pathogenic bacteria were separated,with a positive rate of 34.98%,among which there were 247 Gram-negative,mainly klebsiella pneumoniae（106 strains） and Escherichia coli（72 strains）,and 28.30% klebsiella pneumoniae and 22% Escherichia coli yielded superspectrum β-lactamase,and there were 92 Gram-positive,mainly Staphylococcus aureus（62 strains）,in which separation rate of S.aureus resistant to Methicillin was 25.80%.Pathogenic bacteria were resistant to the majority of antibiotics.Conclusion Pathogenic bacteria of child LRTI in our hospital are mainly Gram-negative,showing multidrug resistance.Antibiotics should be adopted reasonably based on drug sensitive test results,to reduce drug resistant strains.