住院患儿咽拭子培养阳性报告的意义探讨

Clinical significance of positive results of pharyngeal swabs culture for hospitalized children

目的探讨咽拭子培养阳性报告的临床意义,以期指导合理使用抗菌药物。方法查阅医院2011年1月-2O12年12月小儿内科住院患儿行咽拭子培养的病历资料,并分析培养阳性病例的病原菌种类、耐药性及临床抗菌药物的使用,使用WHONET 5.6专业统计软件进行统计分析。结果 2406份咽拭子中分离出病原菌84株,阳性率为3.38%,革兰阳性菌58株占69.04%,革兰阴性菌26株占30.96%;分离率最高的是金黄色葡萄球菌41株占48.81%,其次为肺炎链球菌15株占17.86%,流感嗜血菌15株占17.86%;84例患者的出院诊断上呼吸道感染9例、下呼吸道感染72例、其他疾病3例;有82例使用抗菌药物,使用率为97.62%。结论住院患儿咽拭子培养阳性率较低,咽拭子培养指征及阳性结果评估存有误区。

OBJECTIVE To investigate the clinical significance of the positive results of pharyngeal swab culture for hospitalized children so as to guide the reasonable use of antibiotics. METHODS The medical records of the patients with pharyngeal swab culture in the department of pediatrics during the two years （from Jan, 2011 to Dec, 2012 ）were adopted. Furthermore, the patients with positive reports of pharyngeal swab culture were selected for the analysis of the species of pathogens, drug resistance, and clinical administration of antimicrobial agents, then, WHONET 5. 6 professional statistical software was employed for statistical analysis. RESULTS Totally 84 positive reports of pathogenic bacteria from 2406 throat swabs were identified and the positive rate reached 3. 38%, of which there were 58 strains of gram positive bacteria （69. 04%） and 26 strains of gram- negative bacteria （30.96 %） ; the isolation rate of Staphylococcus aureus was the highest, which reached 48.81% （41 strains）, followed by Streptococcus pneumoniae （ 15 strains, 17. 86%） and Haemophilus influenzae （ 15 strains, 17. 86Y0）. Of 84 cases of patients, there were 9 cases who were diagnosed as the upper respiratory tract infections, 73 cases as the lower respiratory tract infections, and 3 cases as other diseases. There were 82 cases of patients who used antibiotics with the utilization rate of 97.62%. CONCLUSION The positive rate of pharyngeal swab culture is relatively low in the hospitalized children. Meanwhile, the indications of the culture and the evalua- tion of positive reports still take form of confusion.