儿童社区获得性肺炎菌群分布及耐药性分析

Community distribution and drug resistance of children with community acquired pneumonia

目的:探讨儿童社区获得性肺炎的菌群分布及耐药性,为治疗方案提供依据。方法:261例儿童社区获得性肺炎痰液细菌培养阳性患者纳入研究,分析其病原菌分布情况及耐药性。结果:261例标本中以大肠埃希菌、肺炎克雷伯菌、流感嗜血杆菌和金黄色葡萄球菌为主,1岁以下的婴儿为好发年龄;大肠埃希菌、肺炎克雷伯菌对氨苄西林均有较高的耐药性,但对头孢他啶、氨曲南、头孢吡肟、头孢呋辛、亚胺培南、哌拉西林/他唑巴坦敏感性较高;肺炎链球菌对红霉素、四环素耐药率高达75%以上,金黄色葡萄球菌对青霉素、红霉素、克林霉素的耐药率达47%以上,但两者对万古霉素、利奈唑胺均敏感。结论:大肠埃希菌、肺炎克雷伯菌、流感嗜血杆菌和金黄色葡萄球菌为儿童社区获得性肺炎的主要致病菌群,应根据患儿病情选择合适的药物进行治疗。

Objective： To explore the flora distribution and drug resistance of children with community-acquired pneumonia and to provide evidence for the treatment plan. Methods： A total of 261 children with community-acquired pneumonia were selected for pathogen detection with positive sputum bacterial culture and then analyze its pathogenic bacteria distribution and drug resistance. Results： Among the 261 cases,Escherichia coli,Klebsiella pneumoniae,Haemophilus influenzae and Staphylococcus aureus were predominant.Infants under 1 years old were susceptible to infection.The Escherichia coli and Klebsiella pneumoniae were high resistance to ampicillin and the drug susceptibility of Ceftazidine,Amtrazine,Cefepime,Cefuroxime,and Imipenem,Piperacillin/tazobartan was high.The resistance rate of streptococcus pneumoniae to erythromycin and tetracycline was over 75%.The resistance rate of staphylococcus aureus to penicillin,erythromycin and clindamycin was over 47%,but both were sensitive to vancomycin and linezolid. Conclusion： The Escherichia coli,Klebsiella pneumoniae,Haemophilus influenzae and Staphylococcus aureus are the main cause of community-acquired pneumonia in children,should be based on the condition of children choose the appropriate drug for treatment.