反复呼吸道感染患儿病原菌分布与耐药性分析

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

目的探讨反复呼吸道感染患儿病原菌分布及耐药性,为临床合理应用抗菌药物提供参考依据。方法分析2013年1月-2014年12月医院收治253例反复呼吸道感染患儿,进行鼻咽分泌物的病原菌培养与鉴定,并进行药物敏感性检测,对患儿的耐药性采用SPSS 17.0软件进行分析。结果反复呼吸道感染患儿共检出病原菌1 516株,革兰阴性菌1 104株占72.82%,包括流感嗜血杆菌、铜绿假单胞菌、大肠埃希菌,分别占22.69%、13.32%、11.48%,革兰阳性菌412株占27.18%,主要为金黄色葡萄球菌、肺炎链球菌,分别占14.45%、5.54%;铜绿假单胞菌对头孢替坦、头孢呋辛的耐药性较高,分别为91.58%、83.66%,大肠埃希菌对头孢呋辛耐药率较高为46.55%,肺炎链球菌及金黄色葡萄球菌对青霉素的耐药率均较高,分别为88.10%、94.98%。结论患儿反复呼吸道感染病原菌以革兰阴性菌感染为主,且存在一定的个体差异,需进一步提高患儿抗菌药物的合理应用。

OBJECTIVE To explore the distribution and drug resistance of pathogens causing recurrent respiratory tract infections in children so as to provide guidance for reasonable clinical use of antibiotics.METHODS A total of253 children with recurrent respiratory tract infections who were treated in the hospital from Jan 2013 to Dec 2014 were enrolled in the study.The nasopharyngeal secretions were cultured for pathogens,the isolated pathogens were identified,the drug susceptibility testing was carried out,and the statistical analysis was performed for the drug resistance by using SPSS17.0software.RESULTS Totally 1 516 strains of pathogens were isolated from the children with recurrent respiratory tract infections,including 1 104（72.82%）strains of gram-negative bacteria and 412（27.18%）strains of gram-positive bacteria;the Haemophilus influenzae,Pseudomonas aeruginosa,and Escherichia coli were the gram-negative bacteria,accounting for 22.69%,13.32%,and 11.48%,respectively;the Staphylococcus aureus and Streptococcus pneumoniae were the major species of gram-positive bacteria,accounting for 14.45% and 5.54%,respectively.The drug resistance rates of P.aeruginosato cefotetan and cefuroxime were 91.58% and 83.66%,respectively;the drug resistance rate of E.coli to cefuroxime was 46.55%;the drug resistance rates of S.pneumoniae and S.aureus to penicillin were 88.10% and 94.98%,respectively.CONCLUSION The gram-negative bacteria are dominant among the pathogens causing the recurrent respiratory tract infections in the children,and there is a certain individual difference.It is necessary to further improve the reasonable use of antibiotics.