患儿急性下呼吸道感染病原菌分布及耐药性监测

Pathogen distribution and drug resistance monitoring for children with acute lower respiratory infection

目的监测分析患儿急性下呼吸道感染常见病原菌分布及耐药性,从而为临床用药提供科学有效的指导依据。方法选取2009年4月-2012年7月儿科收治的824例急性下呼吸道感染患儿临床资料,采集患儿的痰液进行培养和细菌鉴定,并采用K-B法进行药敏试验,然后对感染病原菌种类及其耐药性进行统计分析。结果824例呼吸道感染患儿送检标本中检测出革兰阴性菌452株占54.9%,革兰阳性菌347株占42.1%,真菌25株占3.0%,主要病原菌为金黄色葡萄球菌、肺炎链球菌、大肠埃希菌等;主要革兰阴性菌中大肠埃希菌和铜绿假单胞菌对氨苄西林的耐药率较高,分别为80.0%、90.0%;主要革兰阳性菌中金黄色葡萄球菌和肺炎链球菌对青霉素G、红霉素的耐药率较高,分别为98.0%、88.0%和78.0%、98.0%。结论患儿下呼吸道感染的病原菌检测中主要以革兰阴性菌为主,应根据病原菌的种类及其耐药性选择有效的抗菌药物进行治疗。

OBJECTIVE To monitor and analyze distribution and drug resistance of common pathogens for children with acute lower respiratory tract infection ,so as to provide scientific and effective guidelines and basis for clinical treatment .METHODS Totally 824 children with acute lower respiratory tract infection admitted in the pediatric clinic of our hospital from Apr .2009 to Jul .2012 were selected ,children′s sputum were collected for culture and identification of bacteria , and the K-B method was used for susceptibility testing and then pathogens were identified and their drug resistance were analyzed statistically . RESULTS According to specimen examination results of 824 children ,452 strains of gram negative bacteria were detected （54 .8% ） ,347 strains of gram positive bacteria （42 .1% ） ,and 25 stains of fungi （3 .0% ） .The main pathogens included Staphylococcus aureus ,Kleb-siella pneumoniae ,and Escherichia coli .Among the main gram negative bacteria ,the resistance of E .coli and P . aeruginosa to ampicillin was high ,being 80 .0% and 90 .0% respectively .Among the main gram positive bacteria , the resistance of S . aureus , K . pneumonia to penicillin ,erythromycin was high ,being 98 .0% ,88 .0% and 78 .0% ,98 .0% respectively .CONCLUSION In children with lower respiratory tract infection ,pathogens detected are mainly gram-negative bacteria .Effective antibiotics should be selected for treatment according to the species of pathogens and their resistance .