520例小儿肺炎痰液病原菌分布及耐药性分析

Analysis of pathogens distribution and drug resistance in 520 children with pneumonia

目的探讨小儿肺炎痰液病原菌分布及耐药性分析。方法对住院的520例小儿肺炎痰液标本进行细菌学培养及药敏试验。结果 520例标本中共分离出致病菌268株,阳性率为51.5%,以革兰阴性菌为主,占68.3%(183株),革兰阳性菌占30.6%(82株)。革兰阴性菌中以肺炎克雷伯菌、大肠埃希菌为主,对氨苄西林耐药率高,对亚胺培南、美洛培南敏感。革兰阳性菌以肺炎链球菌、金黄也葡萄球菌为主,对青霉素、红霉素耐药率高,对万古霉素、利福平敏感。结论小儿肺炎以革兰阴性菌为主,应根据细菌学结果指导抗生素的选择,避免增加耐药性。

Objective To explore the pathogens distribution and drug sensitivity in 520 children with pneumonia.Methods The sputum samples of 520 children with pneumonia were cultured to analyze their pathogens distribution and drug sensitivity.Results 268 strains of pathogenic bacteria（51.5%） were isolated from 520 sputum samples,including 183 strains of gram-negative bacteria（68.3%） and 82 strains of gram-positive bacteria（30.6%）.Klebsiella pneumoniae and Escherichia coli were the main bacteria in gramnegative bacteria,which showed a high drug resistance to ampicillin and a high sensitivity to imipenem and Meropenem.The major grampositive bacteria were streptococcus pneumoniae and staphylococcus aureus,which showed a high drug resistance to penicillin and erythromycin and sensitivity to vancomycin and rifampicin.Conclusion Gram-negative bacteria are the main pathogens in children with pneumonia,and antibiotics should be chosen according to pathogenic bacteria type and drug sensitivity test to avoid the increase of drug resistance.