48例儿童链球菌肺炎发生耐药性的危险因素分析

The risk factor analysis of drug resistance in 48 children with streptococcus pneumonia

目的探讨链球菌肺炎(SP)儿童患者发生耐药菌感染的危险因素以及常见药物耐药情况。方法选取我院儿科病房48例儿童链球菌肺炎患者,对临床分离的48株肺炎链球菌进行药敏试验,针对常见抗菌药物耐药情况以及发生耐药性的危险因素进行分析。结果肺炎链球菌对红霉素、阿奇霉素的耐药率分别为93.75%和91.67%,对氨苄西林、头孢呋辛、头孢曲松敏感率分別为77.1%、83.33%、87.5%。单因素分析显示,年龄、使用疫苗以及就诊前应用抗生素等因素存在统计学差异(P﹤0.05),是儿童链球菌肺炎发生耐药菌感染的危险因素。并表现出多重耐药,尤其对青霉素和红霉素耐药的菌株。结论本医院所在儿科病房患儿链球菌肺炎耐药形势严峻,对多种抗生素呈广泛的不同程度的耐药,引起耐药的危险因素较多,应动态监测肺炎链球菌的耐药情况,合理选择抗生素,提高疗效。

Objective To explore the risk factors of drug resistance in 48 children with streptococcus pneumonia. Methods 48 strains of streptococcus pneumonia were given drug sensitivity test. According to common anti- microbial resistance, the risk factors of drug resistance were analyzed. Results The drug resistance of streptococcus pneumonia to erythromycin and azithromycin was respectively 93.75% and 91.67%. The sensitivity to ampicillin, cefuroxime and ceftriaxone was 77.1% , 83.33% and 87.5% respectively. Single factor analysis showed there were significant differences in age, the use of vaccines and antibiotics use before hospital （ P 〈 0. 05 ）. It showed multiple drug resistance, especially to penicillin and erythromycin. Conclusion The drug resistance of streptococcus pneumonia in the department of paediatrics is serious, showing a certain resistance to many antibiotics. There are many reasons causing the drug resistance, which should be given dynamic monitoring. And the antibiotics should be chosen according to the sensitivity test.