小儿呼吸系统感染病原菌的耐药性分析

Analysis of drug resistance of pathogenic bacteria in respiratory system infection of children

目的:探究小儿呼吸系统感染病原菌的耐药性。方法:2017年5月-2018年5月收治小儿呼吸系统疾病患者240例,共收集痰液样本760份,分析检测结果。结果:760份痰液样本中,检出病原菌255株,阳性检出率33.55%;检测结果显示,革兰阴性菌13种共183株,革兰阳性菌4种共检出30株,真菌3种共42例,检查率间差异较大,差异有统计学意义(P<0.05)。在耐药性方面,铜绿假单胞菌对复方磺胺甲噁唑片及氨苄西林耐药性较高,大肠埃希菌和肺炎克雷伯菌对酰胺类抗生素药物抗药性较高,噬麦芽窄食单胞菌对于碳青霉烯类药物耐药性较高,流感嗜血杆菌对于第二代头孢抗生素及酰胺类抗生素药物耐药率在60%~100%以内,金色葡萄球菌对红霉素、林可氨类药物、左氟沙星等药物敏感度较差,白色念球菌对于抗菌药物具有较高敏感性。结论:小儿呼吸系统感染常见的病原菌对β-内酰胺类的抗生素具有较高的耐药性,在临床用药时,需要在检测之后,按照药敏结果以及病原菌普合理使用药物。

Objective:To explore the drug resistance of pathogenic bacteria in children's respiratory system infection.Methods:From May 2017 to May 2018,240 children with respiratory diseases were selected,and a total of 760 sputum samples were collected.We analyzed the test results.Results:In 760 sputum samples,255 strains of pathogenic bacteria were detected,the positive rate was 33.55%.The results showed that there were 13 kinds of 183 strains of Gram-negative bacteria,4 kinds of 30 strains of Gram-positive bacteria and 3 kinds of 42 cases of fungi,the difference of examination rate was significant(P<0.05).In terms of drug resistance,the resistance of pseudomonas aeruginosa to sulfamethoxazole and ampicillin was high,amide antibiotics was highly resistant to escherichia coli and klebsiella pneumoniae,the resistance of stenotrophomonas maltophilia to carbapenems was high,the resistance rate of haemophilus influenzae to the second generation cephalosporins and amide antibiotics was 60%to 100%,staphylococcus aureus was less sensitive to erythromycin,lincomycin and levofloxacin,candida albicans was highly sensitive to antibiotics.Conclusion:The common pathogens of respiratory infection in children had high resistance toβ-lactam antibiotics,in clinical use,it was necessary to use the drug reasonably according to the results of drug sensitivity and pathogenic bacteria after detection.