某医院儿科患者下呼吸道感染病原菌分布及耐药性分析

Pathogen distribution and drug resistance analysis on respiratory infection in children of some hospital in Aksu area

目的了解医院儿科住院患儿下呼吸道感染病原菌分布及其耐药性,为临床合理使用抗菌药物提供依据。方法采用病原菌分离鉴定技术和药敏试验方法,对新疆某医院儿科下呼吸道感染患儿痰液标本进行检测与分析。结果该医院儿科在1年内从1 198例下呼吸道感染患儿送检痰标本中共分离出病原菌469株,其中革兰阴性菌和革兰阳性菌分别占60.55%和39.45%。分离率居前5位的病原菌分别为铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、人葡萄球菌和金黄色葡萄球菌,构成比依次为15.14%、14.29%、13.86%、10.87%和8.96%。革兰阴性菌对氨苄西林舒巴坦和头孢曲松呈高度耐药,革兰阳性菌对青霉素G和红霉素呈高度耐药。结论该医院儿科患者下呼吸道感染病原菌以革兰阴性菌居多,对常用抗菌药物耐药较为严重,监测感染病原菌分布及耐药状况对抗菌药物的合理选用有重要意义。

Objective To study the pathogen distribution and drug resistance in the lower respiratory tract infection in children of Aksu area,so as to provide reference for reasonable use of antibiotics. Methods The pathogens were isolated from the collected sputum specimens of lower respiratory tract infection from January 2016 to December 2016 in the 1 st People＇s Hospital of Aksu area pediatrics,and the drug resistance of the pathogen was analyzed. Results A total of 469 strains of pathogens were isolated from the sputum specimens of 1198 children with the lower respiratory tract infection.Among them,284 strains（ 60. 55% ） were the gram-negative bacteria,185 strains（ 39. 45% ） were the gram-positive bacteria,and the top five were Pseudomonas aeruginosa（ 15. 14% ）,Klebsiella pneumoniae（ 14. 29% ）,Escherichia coli（ 13. 86% ）,Staphylococcus hominis（ 10. 87% ）,Staphylococcus aureus（ 8. 96% ）. Pseudomonas aeruginosa was highly resistant to Ampicillin sulbactam and Ceftriaxone,while was low resistant to Ceftazidime,Cefepime and Piperacillin Tazobactam; Klebsiella pneumoniae and Escherichia coli were highly resistant to Ampicillin sulbactam,Ceftriaxone,Ceftazidime,Cefuroxime,while were low resistant to Piperacillin tazobactam; Staphylococcus hominis and Staphylococcus aureus were highly resistant to Penicillin G and Erythromycin,while were low resistant to Cefoxitin,Vancomycin,Linezolid and Tigecycline.Conclusion Children with lower respiratory tract infection are mainly infected by gram-negative bacteria in Aksu area,and the drug resistant of commonly used antibiotics is more severe. The monitoring the distribution of pathogens and drug resistance to the selection of sensitive antibiotics is very important.