长沙地区婴儿肺炎356例病原学检测结果

Etiological Detection Results of 356 Infants with Pneumonia in Changsha Area

目的了解婴儿肺炎病原学分布,为临床经验性用药提供参考。方法对2011年10月-2012年9月在长沙市第一医院儿科住院临床诊断为婴儿肺炎的356例患儿,采集鼻咽部分泌物,进行痰细菌培养及直接免疫荧光法检测呼吸道病毒,分析病原学分布情况及细菌耐药性。结果 356例患儿188例检出病毒阳性或痰细菌培养阳性,病原检出率52.8%,其中呼吸道病毒及痰细菌培养检出率分别为34.8%、42.1%。痰细菌培养以肺炎克雷伯菌(28.1%)最常见,混合感染率高达24.2%;超广谱β-内酰胺酶(ESBLs+)及耐青霉素肺炎链球菌(PRSP)菌检出率较高,分别达68.3%、90.0%,细菌的耐药性较强。病毒感染以冬季好发,以呼吸道合胞病毒(RSV)(57.8%)及副流感病毒3(PIV3)(17.2%)为主。结论婴儿肺炎患儿应及时进行病原学检查,以便临床医师根据其结果合理用药。

Objective To explore the distribution of pathogens in infants with pneumonia, and to provide a reference for clinical experiential medication. Methods A total of 356 pediatric patients clinically diagnosed as pneumonia hospitalized in the pediatrics of the First Hospital of Changsha from October 2011 to September 2012 were enrolled in this study. Nasopharyn- geal secretions were collected for sputum bacterial culture and direct irnmunofluorescence detection of respiratory viruses. Etiologi- cal distribution and bacterial drug resistance were analyzed. Results Among 356 infants, the virus or sputum bacterial culture was positive in 188, with an overall positive rate of 52.8%. The positive rates of respiratory virus and sputum culture were 34.8 % and 42.1%, respectively. Sputum culture showed that Klebsiel[a pneumon/ae was the most common （28.1% ）, and the mixed infection rate was up to 24.2 %. The detection rates of ESBLs and PRSP were both higher （68.3 % and 90.0 %, respec- tively）, and bacterial tolerance was also strong. Virus infection was prevalent in winter, and the predominant viruses were RSV （57.8 % ） and PIV3 （17.2 % ）. Conclusions Timely etiological examination is necessary to infants with pneumonia so that the clinicians use appropriate drugs based on the detection results.