儿童下呼吸道感染病原菌分布及耐药性与成人对比分析

Pathogenic bacteria distribution and drug resistance contrastive analysis of lower respiratory infection in children and adults

目的了解住院儿童与成人下呼吸道感染病原菌分布差异及耐药特点,为临床用药提供指导和依据。方法对2011年1月至2012年12月入住儿科与成人呼吸内科下呼吸道感染患者痰培养所分离的病原菌进行菌种分布和耐药性回顾性统计分析。结果儿科下呼吸道感染933株病原菌中革兰阴性杆菌713株,占76.4%,主要是流感嗜血菌40.8%、大肠埃希菌和肺炎克雷伯菌16.4%,革兰阳性球菌206株,占22.1%,主要是金黄色葡萄球菌18.9%,真菌14株,占1.5%。成人呼吸内科880株病原菌中革兰阴性杆菌501株,占56.9%,主要是非发酵菌19%、肠杆菌科细菌18.6%,革兰阳性球菌31株,占3.5%,真菌348株,占39.6%。结论儿童与成人下呼吸道感染病原菌分布及耐药性存在明显差异,临床经验性用药应充分考虑这一点,并及时进行病原学检测,合理选用抗菌药物。

Objective To analyse the pathogenic bacteria distribution difference and drug resistance characteristics of the lower respiratory infection between the hospitalized children and adults. Provide the guidance and basis for clinical medication. Methods This study retrospectively analyzed the bacteria distribution and its drug resistance. The bacteria samples were separated from the sputum culture collected from the internal medicine lrti patients staying in the pediatric and adult respiratory department From January 2011 to December 2012. Results Of the 933 strains of pathogenic bacteria of pediatric lower respiratory tract infection,713 strains were gram negative bacilli,accounted for 76. 4% ,mainly including Haemophilus influenzae 40. 8% , Escherichia coli and Klebsiella pneumoniae 16. 4% ; 206 strains were gram positive coccus,accounted for 22. 1% ,mainly including 18. 9% staphylococcus aureus; 14 strains were fungi,accounted for 1. 5% . Of 880 strains of the pathogenic bacteria from the adult respiratory department of internal medicine,501 strains were gram-negative bacilli,accounted for 56. 9% ,mainly including non-fermentative bacteria 19% ,entero bacteria 18. 6% ; 31 strains were gram positive coccus,accounted for 3. 5% ; 348 strains were fungi,accounted for 39. 6% . Conclusion There are significant difference in the distribution and drug resistance of the pathogenic bacteria in lower respiratory tract infection between children and adults. Clinical empirical treatment should take full account of the differences,detect the aetiology in time,and select the rational antimicrobial drugs.