小儿经鼻腔取痰培养病原菌的分布特点与药敏分析

Pathogenic Bacteria Distribution and Drug Susceptibility Analysis Taken Sputum Bacterial Culture Through Nose in Pediatric Patients

目的通过小儿经鼻腔取痰后的细菌培养结果,了解小儿下呼吸道感染的细菌分布特点,指导儿科医师合理运用抗菌药物。方法回顾性分析2013年7月~2016年6月本院儿科病区经鼻腔取痰样本5 795例的细菌培养结果,并用WHONET5.6软件统计药敏结果。结果 5 795例痰标本共培养病原菌2 535株,A类、B类、C类标本阳性检出率分别为51.29%、36.75%、18.32%,检出率前5位病原菌依次为卡他莫拉菌、肺炎链球菌、金黄色葡萄球菌、流感嗜血杆菌、大肠埃希菌;卡他莫拉菌对红霉素、阿奇霉素的非敏感率最高,为40.93%,β-内酰胺酶阳性率为96.22%;未检出对青霉素耐药的肺炎链球菌;耐甲氧西林金黄色葡萄球菌(MRSA)检出率为9.49%;流感嗜血杆菌对复方新诺明的耐药率最高为36.02%,β-内酰胺酶阳性率为30.65%;未检出对亚胺培南耐药的大肠埃希菌。结论经鼻腔取痰细菌培养未受到口腔菌群的干扰,其结果准确、阳性率高;临床应根据药敏试验结果合理选用抗菌药物,延缓耐药细菌的产生。

Objective To understand the pathogenic bacteria distribution characteristics in children with lower respiratory infection,and guide the rational use of antimicrobial agents pediatricians,we studied sputum bacterial culture results from children’s sample taken from nasal cavity.Methods Retrospective analysis the bacterial culture results of 5 7 9 5 cases of our hospital pediatric ward take sputum sample through nose during July 2 0 1 3-June 2 0 1 6,the statistics of drug susceptibility results with WHONET 5.6 software.Results 5795 cases of sputum specimens detected 2535 strains of pathogenic bacteria,class A,class B and class C specimen positive detection rate of 5 1.2 9%,3 6.7 5%and 1 8.3 2%respectively,Moraxella catarrhalis,Streptococcus pneumoniae,Staphylococcus aureus,Haemophilus influenzae and Escherichia coli were the top five species of pathogens isolated from;The non sensitive rate of Moraxella catarrhalis to erythrocin and azithromycin was the highest(40.93%),the positive rate ofβ-lactamases was 96.22%;Did not check out the drug resistance of streptococcus pneumoniae to penicillin;Methicillin-resistant staphylococcus aureus(MRSA)detection rate of 9.49%;The drug resistance rate of Haemophilus influenzae to compound sulfamethoxazole was the highest(36.02%),the positive rate ofβ-lactamases was 30.65%;The drug resistance of Escherichia coli to imipenem was not found.Conclusion Sputum taken through the nose for bacterial culture is not not impededed by oral bacteria,its results are accurate,high positive rate;Clinical should be more choose antimicrobial agents according to antimicrobial susceptibility test results,delay the produce of drug-resistant bacteria.