小儿下呼吸道感染病原菌分布及耐药性分析

Distribution and drug resistance of pathogens causing lower respiratory tract infections in children

目的探究常用抗菌药物对小儿下呼吸道感染病原菌的耐药性,为临床应用抗菌药物提供依据。方法对医院2009年9月-2012年3月收治的302例下呼吸道感染患儿进行回顾性分析,对其感染病原菌类型及常用抗菌药物敏感性进行探究。结果 302例患儿共检出病原菌149株,其中革兰阴性菌107株占71.8%,以流感嗜血菌和大肠埃希菌为主,革兰阳性菌34株占22.8%,以肺炎链球菌为主,真菌8株占5.4%;革兰阴性菌对阿米卡星、亚胺培南、美罗培南耐药率较低,均<20.0%,革兰阳性菌对呋喃妥因、万古霉素的耐药率均为0。结论小儿下呼吸道感染病原菌感染主要以细菌感染为主,革兰阴性菌分离率较高,而传统氨苄西林、第三代头孢等抗菌药物耐药率均明显升高,应按照病原菌药敏结果,合理选择抗菌药物,以有效清除病原菌,改善预后。

OBJECTIVE To children to the commonly observe the drug resistance of the pathogens causing lower respiratory tract infections in used antibiotics so as to provide guidance for the clinical use of antibiotics. METHODS Totally 302 children with lower respiratory tract infections, who were treated in the hospital from Sep 2009 to Mar 2012, were retrospectively analyzed, then the species of pathogens and the drug susceptibility to the commonly used antibiotics were observed. RESULTS A total of 149 strains of pathogens have been isolated from the 302 chil- dren, including 107 （71.8%） strains of gram-negative bacteria, 34 （22.8%） strains of gram-positive bacteria, and 8 （5.4 % ） strains of fungi; Haemophilus influenzae and Escherichia coli were dominant among the gram-nega- tive bacteria; the Streptococcus pneurnoniae was the predominant species of gram-positive bacteria. The drug re- sistance rates of the gram-negative bacteria to amikacin, imipenem, and meropenem were less than 20.0%; the drug resistance rates of the gram-positive bacteria to nitrofurantoin and vancomycin were 0. CONCLUSION The bacterial infections are dominant among the children with the lower respiratory tract infections; the isolation rate of the gram-negative bacteria is high; the drug resistance rates to the traditional ampicillin and third generation cephalosporins are significantly increased; it is necessary to reasonably use antibiotics according to the result of drug susceptibility testing so as to effectively eradicate the pathogens and improve the prognosis.