0～5岁儿童下呼吸道感染卡他莫拉菌特点及耐药性研究

The characteristics of lower respiratory tract infection by Moraxella catarrhalis in children aged from 0 to 5 years and drug resistance study

目的研究0~5岁儿童下呼吸道感染卡他莫拉菌的病原学特点及耐药性,为临床治疗及流行病学研究提供合理依据。方法收集2014年9月至2016年9月4 815例0~5岁下呼吸道感染患儿病历资料进行回顾性分析。结果 4 815例下呼吸道感染患儿痰标本卡他莫拉菌培养阳性248例,检出率为5.15%,其中肺炎、支气管炎、毛细支气管炎、支气管哮喘分别占70.56%、14.52%、9.27%和5.65%;感染卡他莫拉菌患儿性别比较,差异无统计学意义(P>0.05),不同年龄段、不同季节检出率差异有统计学意义(P<0.05);卡他莫拉菌对阿莫西林/克拉维酸和头孢噻肟敏感率大于95.0%。结论 3岁以下儿童是感染卡他莫拉菌的高危人群,且冬季检出率最高。诊治时应重视年龄和季节因素,及时行鉴定药敏试验,合理选择抗菌药物控制病情。

Objective To study the characteristics of lower respiratory tract infection by Moraxella catarrhalis in children aged from 0to 5years and drug resistance,so as to provide the rational basis for clinical treatment and epidemiology.Methods The medical data from 4 815 children aged 0to 5years with lower respiratory tract infection between September 2014 and September2016were retrospectively reviewed.Results Totally 248 strains of Moraxella catarrhalis were isolated from 4 815 sputum samples,with the isolation rate of 5.15%.Of the isolated Moraxella catarrhalis strains,70.56% were isolated from the children with pneumonia,14.52% were isolated from the children with bronchitis,9.27% were isolated from the children with capillary bronchitis,5.65% were isolated from the children with bronchial asthma.There was no significant difference in the incidence of Moraxella catarrhalis infections between the genders of the children（P0.05）,but the incidence of Moraxella catarrhalis detection rates differed significantly in different seasons and children of different ages（P0.05）.The drug susceptibility rates of Moraxella catarrhalis to Cefotaxime and Amoxicillin-clavulanic acid were more than 95.0%.Conclusion The children aged less than 3years old are at the high risk of Moraxella catarrhalis infection and highest detection rates in winter.The age and season are important factors to make a diagnosis and give treatment,and it is necessary to perform the drug susceptibility testing in a timely manner so as to choose reasonable antimicrobial agents to control the condition.