下呼吸道感染患儿常见病原菌分布与耐药性分析

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

目的探讨下呼吸道感染患儿常见病原菌分布及其耐药性,为合理选择抗菌药物提供依据。方法选取医院2011年6月-2013年6月收治的75例下呼吸道感染患儿,采集患儿痰液标本进行细菌培养及药敏试验,对感染病原菌分布及其耐药性进行统计分析。结果 75例感染患儿培养出病原菌81株,其中革兰阴性菌53株占65.43%,以肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌为主,革兰阳性菌19株占23.46%,以金黄色葡萄球菌和表皮葡萄球菌为主,真菌9株占11.11%;革兰阴性菌对亚胺培南、头孢哌酮/舒巴坦最为敏感,耐药率<5.26%,对氨苄西林、头孢唑林及头孢呋辛耐药率均较高,革兰阳性菌对万古霉素及替考拉宁最为敏感,均为0,而对青霉素G、克林霉素和甲氧苄啶的耐药率较高,>81.82%。结论下呼吸道感染患儿的常见病原菌以革兰阴性菌为主,临床用药时应根据药敏检测结果合理选用抗菌药物。

OBJECTIVE To explore the distribution and drug resistance of common pathogens causing lower respiratory tract infections in children so as to provide guidance for reasonable use of antibiotics.METHODS A total of 75 children with lower respiratory tract infections who were treated in the hospital from Jun 2011 to Jun 2013 were enrolled in the study,then the sputum specimens were collected from the children for bacterial culture,the drug susceptibility testing was performed,and the distribution and drug resistance of the pathogens causing infections were statistically analyzed.RESULTS A total of 81 strains of pathogens have been cultured from the 75 children,including 53（65.43%）strains of gram-negative bacteria,19（23.46%）strains of gram-positive bacteria,and 9（11.11%）strains of fungi;the Klebsiella pneumoniae,Escherichia coli,and Pseudomonas aeruginosa were the predominant species of gram-negative bacteria,and the Staphylococcus aureus and Staphylococcus epidermidis were dominant among the gram-positive bacteria.The gram-negative bacteria were the most susceptible to imipenem and cefoperazone-sulbactam with the drug resistance rate less than 5.26% but were highly resistant to ampicillin,cefazolin,and cefuroxime;the gram-positive bacteria were the most susceptible to vancomycin and teicoplanin with the drug resistance rate of 0but were highly resistant to penicillin G,clindamycin,and trimethoprim with the drug resistance rate more than 81.82%.CONCLUSION The gram-negative bacteria are dominant among the common pathogens causing lower respiratory tract infections in the children.It is necessary for the hospital to reasonably use antibiotics on the basis of the results of the drug susceptibility testing.