2016年玉溪市某院儿童下呼吸道感染细菌菌群分布及耐药性分析

Distribution and drug resistance of bacterial flora in children with lower respiratory tract infections in a hospital at Yuxi,Yunnan in 2016

目的了解本地区儿童下呼吸道感染常见细菌分布特点及对抗生素的耐药情况。方法回顾2016年5 857例呼吸道感染患儿痰标本行细菌培养鉴定及药敏试验,对细菌分布特点及细菌耐药情况行统计学分析。结果在待测痰标本中,病原菌分离率为26%,不同季节及年龄段细菌菌群分布存在差异。分离菌株中革兰阴性菌以大肠埃希菌(E.coli,21.5%)、流感嗜血杆菌(HIN,16.8%)和肺炎克雷伯菌(KPN,6.7%)为主;大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBL)菌株分别占49.7%和33.1%;流感嗜血杆菌对头孢菌素类、阿莫西林/克拉维酸及阿奇霉素敏感;革兰阳性菌以金黄色葡萄球菌(SAU,9.9%)、肺炎链球菌(SPN,9.5%)为主,未发现万古霉素耐药菌株。结论本地区儿童下呼吸道细菌感染存在年龄和季节分布差异,各细菌耐药性有其自身特点,建议临床依据药敏试验结果合理用药。

Objective To investigate the distribution of common bacteria and antibiotic resistance in children with lower respiratory tract infections at Yuxi area. Methods The sputum samples from 5 857 children with respiratory tract infection were collected for bacterial culture,identification and drug sensitivity test in 2016. The distribution of bacteria and drug resistance of bacteria were statistically analyzed. Results The isolation rate of pathogenic bacteria was 26% in the tested sputum specimens. The distribution of bacterial flora was different in different seasons and ages. The Gram-negative bacteria among the isolated strains were mainly Escherichia coli（E.coli,21.5%）,Haemophilus influenzae（HIN,16.8%）and Klebsiella pneumoniae（KPN,6.7%）. Escherichia coli and Klebsiella pneumoniae producing extended-spectrum beta-lactamase（ESBL）strains accounted for 49.7% and 33.1% respectively. Haemophilus influenzae is sensitive to cephalosporins,amoxicillin-clavulanic acid and azithromycin. Gram-positive bacteria were mainly Staphylococcus aureus（SAU,9.9%）,Streptococcus pneumoniae（SPN,9.5%）,and vancomycin resistant strains were not isolated. Conclusion There are differences in age and season distribution in children with respiratory tract bacterial infection at Yuxi area. The drug resistance of each bacterium has its own characteristics,suggesting that the clinical use of drug sensitivity test is reasonable.