儿科患者呼吸道感染常见病原菌及耐药性分析

Distribution and Drug Resistance of Common Pathogenic Bacteria Causing Respiratory Tract Infection in Pediatrics

目的:探讨儿科呼吸道感染疾病常见病原菌的分布情况及耐药性,为抗菌药物的临床使用提供参考。方法:对本院住院患儿的呼吸道标本进行培养,用法国梅里埃ATB-EXPRESS自动化细菌鉴定及药敏分析系统鉴定及做药敏,按美国临床和实验室标准协会CLSI 2012年标准,采用WHO-NET5.6软件进行统计分析。结果:517株细菌中前6位依次为流感嗜血杆菌、金黄色葡萄球菌、大肠埃希菌、肺炎链球菌、肺炎克雷伯菌和卡他莫拉菌。大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶株(ESBLs)检出率分别为53.5%和22.2%,流感嗜血杆菌产β-内酰胺酶阳性率为48.1%,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为22.0%。结论:儿科患者临床分离病原菌对多种抗菌药物的耐药率逐年上升。为了减少细菌耐药率、延缓耐药菌株的出现,临床应重视病原学的检测及加强耐药监测。

Objective：To investigate the bacterial distribution and the drug resistance of common pathogenic bacteria causing respiratory tract infection in pediatrics so as to provide clinical reference in the use of antibacterial agents. Method：Sputum specimens for bacterial cultures were collected from pediatric inpatients.Bacterial identification and susceptibility test were performed by automated system called ATB-EXPRESS.Results were analyzed by WHONET 5.6 referring to the breakpoints of CLSI 2012.Result：A total of 517 strains of pathogens were isolated from sputum specimens. The most common isolates were H.inflenzae,S.aureus,E.coli,S.pheumoniae,K.pheumoniae and M.catarrhalis. The prevalence of ESBLs-producing strains was 53.5% in E.coli and 22.2% in K.pneumoniae.Methicillin-resistant Staphylococcus aureus（MRSA）detection rates was 22.0%.The prevalence of β-lactamase strains was 48.1% in H.inflenzae.Conclusion：The antibiotic resistance of clinical bacterial isolates is growing in Pediatrics.Therefore,it is necessary to pay attention to the pathogens detection and strengthen bacterial resistance surveillance in order to reduce the resistant rates of bacteria and delay the occurrence of bacterial resistance.