儿童肺炎链球菌感染的临床特征及耐药性分析

Clinical characteristics and drug resistance of Streptococcus pneumoniae infection in children

目的探讨儿童肺炎链球菌感染的临床特征及耐药性,为临床肺炎链球菌感染的治疗提供依据。方法选择于2015年6月-2016年6月医院收治的473例确诊为肺炎链球菌感染的患儿为试验组,选择同期于医院健康检查的儿童280名为对照组,对试验组患儿进行肺炎链球菌培养鉴定及药敏分析,并记录试验组患儿临床特征,检测并比较两组研究对象的白细胞计数、中性粒细胞比值及血清C-反应蛋白(CRP)水平。结果 473例肺炎链球菌感染患儿中,年龄分布主要为≤2岁291例占61.52%,发病季节分布以冬季247例占52.22%为主,标本分布以痰标本429例占90.70%为主,疾病分布以肺炎344例占72.73%为主;473株肺炎链球菌对厄他培南、万古霉素、利奈唑胺及莫西沙星的敏感率最高,均为100.00%,而对红霉素耐药率最高为97.67%;试验组白细胞计数、中性粒细胞比值及血清CRP水平均高于对照组(P<0.05)。结论儿童肺炎链球菌感染主要以<5岁儿童为主,冬季发病率最高,且急性期炎性反应较为明显,肺炎链球菌对红霉素耐药率极高,不适用于临床治疗,临床中应根据药敏结果选择合适的抗菌药物。

OBJECTIVE To investigate the clinical characteristics and drug resistance of S.pneumoniae infection in children,so as to provide basis for the treatment of S.pneumoniae.METHODS A total of 473 cases of patients confirmed for S.pneumoniae infection admitted to the hospital from Jun.2015 to Jun.2016 were selected as observation group,and 280 cases of children for health examination were set as control group.Culture,identification and drug resistance analysis of Streptococcus pneumoniae were carried in observation group of children,and clinical features were observed.The white blood cell count,neutrophil ratio and serum C reactive protein（CRP）of the two groups were detected and compared.RESULTS Among 473 cases of S.pneumoniae infection,the age distribution was mainly below 2 years old in 291 cases（61.52%）,the seasonal distribution was mainly the winter of 247 cases（52.22%）,the distribution of samples was mainly sputum specimens of 429 cases（90.70%）,and the distribution of disease was mainly pneumonia for 344 cases（72.73%）.The 473 strains of S.pneumoniae had the highest sensitive rates to ertapenem,vancomycin,linezolid and moxifloxacin,which were 100%,and had the highest resistant rate to erythromycin,which was 97.67%.The WBC count,neutrophil ratio and serum CRP level in observation group were significantly higher than those in control group（P〈0.05）.CONCLUSIONChildren with S.pneumoniae infection are mainly under the age of 5,with the highest incidence of winter,inflammatory reaction and acute phase is more obvious,S.pneumoniae has high resistant rate to erythromycin,and is not suitable for clinical treatment,so the appropriate antimicrobial agents should be selected according to the results of drug sensitivity in the clinic.