儿童社区获得性肺炎病原体及细菌药敏结果分析

Pathogens and antibiotic resistance of community-acquired pneumonia in children

目的了解2011年医院儿童社区获得性肺炎(CAP)感染病原体类型及细菌的耐药情况。方法收集患儿痰液,进行菌种鉴定,KB纸片法进行药敏试验;非典型病原体、呼吸道合胞病毒等采用免疫荧光法检测鉴定。结果 651例CAP患儿病原体感染385例,感染率为59.14%,其中检出细菌142株,病毒105株,非典型病原体138株。检出菌株数最多的是肺炎支原体,为108株(占28.05%),其次为呼吸道合胞病毒,为54株(占14.03%),其他病原体,如嗜血杆菌(47株),副流感病毒(27株),肺炎衣原体(23株)和肺炎链球菌(21株)。患儿混合感染89例,以病毒和细菌混合感染为主。嗜血杆菌对环丙沙星耐药率最高,为55.32%;嗜血杆菌、肺炎链球菌和肺炎克雷伯菌对阿奇霉素、万古霉素、阿莫西林/克拉维酸敏感。结论 CAP患儿以肺炎支原体感染为主,分离细菌对常见抗生素耐药性较低。

Objective To investigate the pathogens and antibiotic resistance of community-acquired pneumonia（CAP） in children.Methods Pathogens were isolated from sputum specimens,drug sensitivity testing was done using the disc diffusion method（K-B method）,and atypical pathogens and viruses were detected using immunofluorescence Results A total of 385 strains of pathogens were isolated from 651 children with CAP.These consisted of 142 strains of bacteria,105 strains of viruses,and 138 strains of atypical pathogens.The pathogen most often detected was Mycoplasma pneumoniae（MP）,with 108 strains detected.There were 54 strains of respiratory syncytial virus,47 of hemophilus,27 of parainfluenza virus,23 of Chlamydia pneumoniae,and 21 of Streptococcus pneumoniae.Eighty-nine children had a mixed infection.Hemophilus was resistant to ciprofloxacin and sensitive to azithromycin,vancomycin,and amoxicillin/clavulanate potassium.Conclusion MP was the predominant pathogen in children with community-acquired pneumonia.The isolates had little drug resistance.