儿童呼吸道革兰阴性杆菌感染状况及耐药性分析

Analysis of infection rate and antibiotic resistance of Gram-negative Bacillus in children with Respiratory Tract Infection

目的：了解儿童呼吸道革兰阴性杆菌感染状况及耐药情况。为临床合理用药提供参考。方法：对本院2012年1~11月儿科呼吸道感染患者的痰标本进行培养鉴定和药敏试验结果进行回顾性分析。结果：918份标本中共检出病原菌507株,检出率为55.2%。其中革兰阴性杆菌224株,占44.2%,以大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、产气肠杆菌和铜绿假单胞菌为主,分别占39.7%、11.6%、10.3%、8.0%和6.7%。大肠埃希菌和肺炎克雷伯菌对阿莫西林、哌拉西林、头孢噻吩耐药率均大于80%,对美诺培南、亚胺培南100%敏感。铜绿假单胞菌对氨苄西林的耐药率最高（93.3%）,对美诺培南、亚胺培南全部敏感。结论：临床应重视病原菌的检测和耐药性监测,临床治疗应根据药敏结果合理选择抗菌素,防止多药耐药菌的增加。

Objective To investigate the clinic distribution and antibiotic resistance of the Gram-negative bacillus in children with respiratory tract infection and to providing experimental basis that clinical doctors use antibiotic correctly and efficiently. Methods A retrospective analysis was made on sputum cultivation and antibiotic resistance test results of respiratory tract infection children in pediatrics our hospital from Jan 2012 to Nov 2012; Results ：507 strains were isolated from 918 samples,positive rate was about 55.2%.Gram-negative bacillus accounted for 44.2%（224） of the positive culture results.The major Gram-negative bacillus were Escherichia coli（39.7%）,Klebsierlla pneumonlae（11.6%）,Enterobacter cloacae（ I0.3 %）,Enterobacter aerogenes （8.0%） and Pseudomonas aernginosa（6.7%）.Antimicrobial resistance testing showed that Escherichia coli and Klebsierlla pneumoniae had the most resistance to amoxicillin,piperacillin and cefalotin （〉80%）, them were sensitive to meropenem and imipenem.Pseudomonas aernginosa had the highest resistance rate to ampicillin（93.3%）,hut sensitive to meropenem and imipenem. Conclusion It is necessary to paid attention to detec- tion of pathogens and susceptibility test in clinical practice. Clinical treatment should be chosen according to antimicrobial susceptibility test,to reduce the incidence of muti-drug-resistant bacteria.