社区获得性肺炎患儿肺炎支原体感染的临床特征及药敏情况分析

Clinical characteristics and drug sensitivity of mycoplasma pneumoniae infection in children with community acquired pneumonia

目的社区获得性肺炎患儿肺炎支原体(MP)感染的临床特征及药敏情况,为临床合理用药提供依据。方法选择西安交大第一附属医院长安区医院儿科2016年9月至2018年9月收治的480例社区获得性肺炎患儿为研究对象,收集其咽拭子标本,进行MP培养鉴定和药敏试验,分析MP感染的临床特征及药敏试验结果。结果 MP阳性率为32.92%。患儿临床表现为持续性发热,发热持续时间(9.2±3.1)d,呼吸道症状持续时间(17.2±5.0)d,平均最高体温为(39.2±1.0)℃。不同年龄段患儿MP阳性率比较,差异具有统计学意义(P<0.05);不同季节MP阳性率比较,差异具有统计学意义(P<0.05);不同性别MP阳性率比较,差异无统计学意义(P>0.05)。药敏试验结果显示,药物敏感率由高到低依次为阿奇霉素、克林霉素、红霉素、罗红霉素、克拉霉素及乙酰螺旋霉素。结论 MP在社区获得性肺炎患儿中的感染率较高,以婴幼儿期为主,夏、秋季易发,MP对大环内酯类抗生素耐药程度较高,临床应重视MP培养及药敏试验,合理选用抗菌药物。

Objective To analyze the clinical characteristics and drug sensitivity of mycoplasma pneumoniae(MP)infection in children with community acquired pneumonia, so as to provide basis for rational drug use in clinic. Methods A total of 480 children with community acquired pneumonia admitted in Chang’an District Hospital of the First Affiliated Hospital of Xi’an Jiaotong University from September 2016 to September 2018 were selected as the research objects.Pharyngeal swab specimens were collected for MP culture and identification and the drug sensitivity test. The clinical characteristics and drug sensitivity test results of MP infection were analyzed. Results The positive rate of MP was 32.92%. The clinical manifestations of the children were persistent fever, fever duration was(9.2 ±3.1) days, respiratory symptoms duration was(17.2 ±5.0) days, and the average maximum body temperature was(39.2 ±1.0) ℃. There was significant difference in MP positive rates among different age groups(P<0.05);there was significant differences in MP positive rates among different seasons(P <0.05). There was no significant difference in MP positive rates between different genders(P>0.05). The results of AST showed that the drug sensitivity rates from high to low were azithromycin,clindamycin, erythromycin, roxithromycin, clarithromycin and acetylspiramycin. Conclusion The infection rate of MP was high in children with community acquired pneumonia, mainly in infants, susceptible in summer and autumn, and the resistance of MP to macrolide antibiotics was higher. We should pay attention to MP culture and drug sensitivity test, and use antibiotics rationally in clinic.