咽拭子标本菌株分离培养鉴定联合药敏试验在手足口病患儿中的应用价值

Application value of isolation and culture identification of pharyngeal swab specimens combined with drug susceptibility test in children with hand-foot-mouth disease

目的分析咽拭子标本菌株分离培养鉴定联合药敏试验在手足口病(HFMD)患儿中的应用价值。方法选取我疾控中心收治的180例HFMD患儿作为研究对象,对其进行咽拭子细菌分离培养鉴定及药敏试验,总结病原菌分类及耐药情况。结果180例HFMD患儿咽拭子标本中,共检出61株致病菌,检出率为33.89%,包含13株革兰阳性菌,43株革兰阴性菌,5株白色假丝酵母菌。副流感嗜血菌、流感嗜血菌对四环素、磺胺甲恶唑/甲氧苄啶、氨苄西林耐药率较高,对氧氟沙星、头孢噻肟、利福平、阿莫西林/克拉维酸相对敏感。肺炎链球菌对磺胺甲恶唑/甲氧苄啶、四环素、克林霉素、红霉素耐药率较高,对万古霉素、左氧氟沙星、奎奴普丁/达福普汀、头孢噻肟相对敏感。结论 HFMD患儿咽部致病菌以嗜血菌属为主,其次为肺炎链球菌、白色假丝酵母菌,结合药敏试验,可为临床选取合理、安全、正确抗菌药物提供依据。

Objective To analyze the application value of isolation and culture identification of pharyngeal swab specimens combined with drug susceptibility test in children with hand-foot-mouth disease(HFMD). Methods A total of180 cases of children with HFMD in our centers for disease control and prevention were selected as the research objects.The bacteria isolated from pharyngeal swab and drug sensitivity test were used to summarize the classification and drug resistance of pathogenic bacteria. Results Among 180 cases of HFMD, 61 strains of pathogenic bacteria were detected, the detection rate was 33.89%, including 13 strains of Gram-positive bacteria, 43 strains of Gram-negative bacteria and 5 strains of Candida albicans. Haemophilus parainfluenzae and Haemophilus influenzae had higher resistance rates to tetracycline, sulfamethoxazole/trimethoprim and ampicillin, and which were relatively sensitive to ofloxacin, cefotaxime,rifampicin and amoxicillin/clavulanic acid. Streptococcus pneumoniae was more resistant to sulf aminomethazole/trimethoprim, tetracycline, clindamycin and erythromycin, and which was relatively sensitive to vancomycin, levofloxacin,quinoputin/dafostine and cefotaxime. Conclusion Hemophilus is the main pathogenic bacteria in pharynx of HFMD children, followed by Streptococcus pneumoniae and Candida albicans. Combined with drug sensitivity test, it can provide a basis for clinical selection of reasonable, safe and correct antibiotics.