鲁南地区小儿支气管肺炎常见病原菌分布及耐药性监测分析

Distribution and drug resistance of common pathogenic bacteria in children with bronchitis in southern Shandong

目的分析调查鲁南地区儿科常见病原菌分布和耐药情况,为临床用药提供理论依据.方法随机选取2016年1月至2018年6月枣庄市妇幼保健院收治的小儿支气管肺炎患者1000例,采集其深部痰液,进行标本培养、鉴定及药敏试验,并对其常见病原菌分布及细菌耐药情况进行统计分析.结果鲁南地区小儿支气管肺炎常见病原菌主要是革兰阴性菌,占37.68%;革兰阳性菌占29.10%;病毒占19.64%;真菌占7.50%.以春冬季感染发生率最高.革兰阴性菌中流感嗜血杆菌感染发生率最高,对美罗培南较为敏感.革兰阳性菌中以肺炎链球菌感染发生率最高,对万古霉素、利奈唑胺较为敏感.结论鲁南地区小儿支气管肺炎的常见致病菌主要为革兰阴性菌,其耐药性均比较严重,提示合理使用抗菌药物是治疗关键.

Objective To provide theoretical basis for clinical medication by analyzing and investigating the distribution and drug resistance of common pediatric pathogens in southern Shandong.Methods One thousand children with bronchopneumonia in Zaozhuang Maternal and Children Health Hospital from January 2016 to June 2018 were randomly selected.Deep sputum of these children were cultured,and identification and drug sensitivity test of these specimen were done subsequently.Distribution and drug resistance of common pathogens were statistically analyzed.Results Gram-negative bacteria accounted for 37.68%,Gram-positive bacteria 29.10%,viruses 19.64%and fungi 7.50%respectively.The incidence of infection was the highest in spring and winter.Haemophilus influenzae was the most susceptible Gram-negative bacteria to meropenem.The incidence of Streptococcus pneumoniae infection was the highest among Gram-positive bacteria,which was sensitive to vancomycin and linezolid.Conclusions Gram-negative bacterias are the most common pathogens of bronchopneumonia in children in southern Shandong,with severe drug resistance.Therefore the rational use of antibiotics is the key to treatment.