PICU下呼吸道感染患儿非发酵革兰阴性杆菌耐药现状分析

Current status of resistance of non-fermented Gram-negative bacilli causing lower respiratory tract infection in PICU

目的了解儿童重症监护病房(PICU)下呼吸道感染患儿主要病原菌的分布及其耐药性,指导临床合理使用抗菌药物。方法收集2008年2月-2011年1月PICU住院患儿下呼吸道分泌物分离的病原菌,对其进行菌株鉴定和药物敏感试验。结果 PICU下呼吸道感染痰标本细菌中,非发酵革兰阴性杆菌678株,占67.3%;分离率居前5位的革兰阴性杆菌依次为:铜绿假单胞菌占31.4%、鲍氏不动杆菌占29.8%、肺炎克雷伯菌占11.3%、大肠埃希菌占10.8%、嗜麦芽寡养单胞菌占4.6%,以上菌株对常用抗菌药物均产生了严重的耐药性。结论 PICU下呼吸道感染以非发酵革兰阴性杆菌为主,且多为多药耐药菌,临床治疗应根据药敏结果使用抗菌药物。

OBJECTIVE To investigate the distribution and resistance of main pathogens with lower respiratory tract infection in pediatric intensive care unit. METHODS The pathogens from the lower respiratory tract specimens were isolated and cultured from the patients in hospital from Feb 2008 to Jan 2011,and the strains were identified and the antibiotic resistance tested. RESULTS Totally pathogenic bacteria strains isolated in pediatric Intensive care unit,non-fermented Gram-negative bacilli accounted for 67.3%.The isolating rates of the first five of non-fermented Gram-negative bacilli were Pseudomonas aeruginosa（31.4%） Acinetobacter baumannii（29.8%）,Klebsiella pneumoniae（11.3%）,Escherichia coli（10.8%） and Stenotrophomonas maltophilia（4.6%）.These strains were commonly used antimicrobial agents have had a serious drug resistance. CONCLUSION The bacteria causing lower respiratory tract infection in pediatric intensive care unit are mainly non-fermented Gram-negative bacilli and show the trend of multidrug resistence.Clinical treatment should be chosen according to the antimicrobial susceptibility test.