296例儿童CAP革兰阴性致病菌分布及耐药性分析

Analysis of gram-negative pathogenic bacteria and drug resistance in 296 children with community-acquired pneumonia

目的探讨本院儿童社区获得性肺炎(CAP)革兰阴性菌感染情况及药敏情况,为抗菌药物合理使用提供依据。方法以2015年1月至2017年12月在本院儿科住院的社区获得性肺炎,且痰培养为革兰阴性菌为研究对象,回顾分析CAP革兰阴性致病菌分布和耐药情况。结果致病菌排前六位分别是大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、普通变形杆菌、卡他莫拉菌、洋葱假单胞菌。药敏结果显示:阿莫西林、头孢呋辛耐药率高,对本院常见的4种革兰阴性菌普遍耐药。三代头孢对大肠埃希菌、普通变形杆菌敏感性高,对铜绿假单胞菌和肺炎克雷伯菌耐药率高。头孢吡肟对大肠埃希菌、普通变形杆菌敏感性高,对铜绿假单胞菌敏感性差,耐药率高达48.07%。泰能对排名前4种革兰阴性菌敏感,但也有耐药株产生,特别是铜绿假单胞菌。结论了解当地儿童社区获得性肺炎病原菌分布及耐药情况,有利于在儿童CAP经验性治疗时制定正确的治疗方案。

Objective To investigate the infection and susceptibility of gram-negative bacteria of community acquired pneumonia (CAP) in children in our hospital.Methods The distribution and drug resistance of CAP gram-negative pathogenic bacteria were retrospectively analyzed with community-acquired pneumonia hospitalized in the pediatric department of our hospital from January 2015 to December 2017 and sputum culture as gram-negative bacteria as the research object.Results The top six pathogenic bacteria were escherichia coli,pseudomonas aeruginosa,klebsiella pneumoniae,common proteus,cartamora,and pseudomonas onion.The results showed that amoxicillin and cefuroxime had high drug resistance rates and were generally resistant to 4 gram-negative bacteria commonly found in our hospital.Three generations of cephalospores have high sensitivity to escherichia coli and common proteus,and high drug resistance to pseudomonas aeruginosa and klebsiella pneumoniae.Cefepime is highly sensitive to escherichia coli and common deformed bacillus,and has poor sensitivity to pseudomonas aeruginosa,with drug resistance rate as high as 48.07%.Tylenol is sensitive to the top four gram-negative bacteria,but there are also drug-resistant strains,especially pseudomonas aeruginosa. Conclusion To understand the distribution and drug resistance of pathogenic bacteria of community-acquired pneumonia in local children is conducive to the development of correct treatment plans for children in the experimental treatment of CAP.