我院儿童下呼吸道感染病原菌分布与药敏结果分析

An Analysis of Pathogenic Bacteria Distribution and Drug Susceptibility in Lower Respiratory Tract Infection in Children in Our Hospital

目的:了解我院儿童下呼吸道感染病原菌分布及其药敏情况,以指导临床合理选用抗菌药物。方法:对2011年我院儿科住院患儿痰培养阳性结果进行回顾性统计分析。结果:共分离出病原菌784株,其中革兰阴性菌565株(72.07%),主要为大肠埃希菌、肺炎克雷伯菌、流感嗜血杆菌,对氨苄西林/舒巴坦、哌拉西林/他唑巴坦、头孢他啶、美罗培南高度敏感;革兰阳性菌75株(9.57%),主要为金黄色葡萄球菌和表皮葡萄球菌,对头孢唑林、苯唑西林敏感,对万古霉素高度敏感。结论:我院儿童下呼吸道感染病原菌以革兰阴性菌为主,对常用青霉素、第一代和第二代头孢菌素耐药率较高,对头孢他啶、哌拉西林/他唑巴坦、氨苄西林/舒巴坦、美罗培南等高度敏感。经验性治疗时,建议选择革兰阴性菌敏感性高的抗菌药物。

Objective： To understand the situations of pathogenic bacteria and their drug sensitivity in lower respiratory tract infection in children in our hospital, and to guide the clinical rational use of antimicrobial drugs. Methods： Positive sputum culture results of pediatric hospitalized children in our hospital in 2011 were retrospectively analyzed. Results： Seven hundreds and eighty-four strains of pathogens were isolated, including 565 strains of Gram-negative bacteria （72. 07% ） and 75 strains of Gram-positive bacteria （9.57%）. Gram-negative bacteria consisted mainly of Escherichia coli, Streptococcus Klebsiella pneumoniae, and Haemophilus influenzae; they were highly sensitive to ampicillin/sulbactam, piperacillin/tazobactam, ceftazidimc, meropenem; Gram-positive bacteria consisted mainly of Staphylococcus aureus and epidermidis ; they were sensitive to cefazolin and oxacillin, and highly sensitive to vancomycin. Conclusions： The pathogenic bacteria in lower respiratory tract infection were mainly Gram-negative bacteria, which were resistant to penicillin, the first and the second generation cephalosporin, and were highly sensitive to ceftazidime, piperacillin/ tazobaetam, ampicillin/sulbactam, and meropenem. It is recommended to choose antibacterial agents against Gram-negative bacteria for empiric treatment.