儿科病房呼吸系统常见病原菌及耐药性分析

Distribution of common pathogenic bacteria isolated from respiratory system and antibiotics resistance

目的分析2011年儿科呼吸系统疾病常见病原菌分布及耐药性,为抗菌药物合理使用提供依据。方法对儿科1209份细菌学检测标本进行统计分析。结果病原菌检出率31.12%,前5位为肺炎链球菌、大肠埃希菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌和肺炎克雷伯菌,分别占18.40%、14.40%、12.53%、10.40%和10.13%;大肠埃希菌对庆大霉素、氨曲南、头孢菌素类、磺胺甲恶唑/甲氧苄啶、氨苄西林/舒巴坦耐药率均≥59.26%;凝固酶阴性葡萄球菌中表皮葡萄球菌对甲氧西林、哌拉西林/他唑巴坦、美罗培南、阿奇霉素、头孢菌素二～四代、苯唑西林、阿莫西林和克林霉素耐药率均≥50.06%;金黄色葡萄球菌对阿奇霉素、克拉霉素、克林霉素、磺胺甲噁唑/甲氧苄啶耐药率46.15%～51.28%;肺炎克雷伯菌对头孢菌素类、氨曲南、氨苄西林/舒巴坦和哌拉西林的耐药率均≥55.26%。结论儿科呼吸系统常见病原菌分别对其常规治疗抗菌药物表现不同程度的耐药性,临床医师应在掌握流行病学基础上,根据经验治疗结合药敏结果合理选用抗菌药物。

OBJECTIVE To investigate the distribution and drug resistance of the common pathogens isolated lrom the respiratory system of the pediatric department patients so as to provide basis for the reasonable use of antibiotics. METHODS A total of 1209 clinical specimens collected for bacteriological test were statistically analy^ed. RESULTS The bacterial detection rate of the pediatric respiratory system was 31.12%. The top five species of pathogens with the highest isolation rates were Streptococcus pneumoniae （18.40%）, Escherichia coli （14.40M）, coagulase-negative Staphylococcus （ 12. 53%）, Staphylococcus aureus （ 10. 40%） and Klebsiella pneumoniae （10.13%）. The antibiotics resistance rates of the E. coli strains to gentamicin, aztreonam, cephalo- sporins, TMP-SMZ, and ampicillin/sulbactam were higher than 59.26%; the drug resistance rates of eoagulase- negative taphylococcus epidermidis to methicilIin sodium, piperacillin/tazobactam, meropenem, azithromycin, bi-/ tri-/tetro-cephaIosporins, oxacilfin, amoxicilIin, and clindamyein were higher than 50. 06~. The drug resistance rate of the S. aureus strains to azithromyein, clarithromycin, clindamycin, and SMZ-TMP varied from 46. 15% and 51. 28%. The drug resistance rates of the K. pneumoniae strains to cephalosporin, aztreonam, ampici[Iin/suIbactam, and piperacillin were higher than 55.26%. CONCLUSION The common species of pathogens isolated from the respiratory tract of pediatric department vary in the drug resistance to the commonly used antibiotics, thus, it is necessary to for the clinician to understand the epidemiology and reasonably use antibiotics based on the result of the drug susceptibility testing.