儿童社区获得性肺炎细菌病原学检测结果分析

Bacterial Etiology Analysis of Children with Community-acquired Pneumonia

目的:分析成都市龙泉驿区儿童社区获得性肺炎(CAP)的细菌病原学分布,为抗生素的合理使用提供有力的实验室依据。方法:选取2014年1月-2015年10月在笔者所在科室住院确诊的CAP患儿885例为研究对象,在入院当天取下其呼吸道分泌物进行一般细菌培养,对培养出的菌群进行菌种鉴定。结果:885例CAP患儿中病原学检测阳性者372例(42.03%):其中革兰氏阳性菌180株,占48.39%,革兰氏阴性菌192株,占51.61%。革兰阳性菌主要为肺炎链球菌145株(38.98%)和金黄色葡萄球菌32株(8.60%);革兰阴性菌主要为流感嗜血杆菌81株(21.77%)、大肠埃希菌50株(13.44%)和卡他莫拉菌28例(7.53%)。≤1岁患儿肺炎链球菌、流感嗜血杆菌、大肠埃希菌、金黄色葡萄球菌、卡他莫拉菌的感染机会均明显高于>1岁患儿,差异均有统计学意义(P<0.05)。结论:肺炎链球菌、流感嗜血杆菌、大肠埃希菌、金黄色葡萄球菌和卡他莫拉菌是儿童CAP的主要细菌病原体,1岁以内的婴幼儿感染的机会高于1岁以上的儿童。

Objective： To analyze the bacterial etiology distribution of children with community-acquired pneumonia（CAP） in Longquanyi district, providing powerful laboratory basis for the rational use of antibiotics.Method ： Eight hundred and eighty-five children with CAP admitted to our department from January 2014 to October 2015 were selected as the objects, the respiratory secretions of all patients were taken for general bacteria culture on ｜he day of admission, the bacteria of sputum culture were then identified.Result： In the 885 children with CAP, the positive etiology detection was 372 cases（42.03%）, including ] 80 strains of gram-positive bacteria, which accounting for 48.39%, and 192 strains of gram-negative bacteria, which accounting for 51.61%.Gram-positive bacteria were mainly for 145 strains（38.98%） of streptococcus pneumoniae and 32 strains（8.60%） of staphylococcus aureus.Gram-negative bacteria were mainly for 81 strains（21.77%） of haemophilns influenzae, 50 strains（13.44%） of e.coli and 28 strains（7.53%） of Moraxella catarrhalis.The risks of streptococcus pneumoniae, haemophilus influenzae, e.coli, staphylococcus aureus, amd Moraxella catarrhalis infections in infants ≤1 year old were significantly higher than children 〉1 year old, the differences were statistically significant（P〈0.05）.Conclusion： The main bacterial pathogens of CAP were streptococcus pneumoniae, haemophilus influenzae, e.coli, staphylococcus aureus and Moraxella catarrhalis, the infection opportunity in infants within one year old than children over the age of one.