小儿呼吸道感染细菌病原菌分布及对抗菌药物的耐药性

Distribution and Drug Resistance of Bacterial Pathogens in Children with Respiratory Tract Infection

目的探讨小儿呼吸道感染细菌病原菌分布和对抗菌药物耐药的状况。方法选取大连市中心医院2017年3月至2018年12月收治的呼吸道感染患儿402例作为研究对象,对所有患儿的痰标本进行细菌病原菌类型培养,并开展药敏试验。结果检测病原菌138株,阳性率为34.33%;其中,革兰阳性菌72株,占52.17%;革兰阴性菌63株,占45.65%;真菌3株,占2.17%。金黄色葡萄球菌、大肠埃希菌、肺炎链球菌、肺炎克雷伯菌及流感嗜血杆菌占据病原菌前5位;金黄色葡萄球菌对红霉素、青霉素最不敏感,对四环素、左旋氧氟沙星、庆大霉素、复方新诺明、利福平较为敏感,对奎奴普丁/达福普汀、莫西沙星、万古霉素、利奈唑胺最敏感;肺炎链球菌对克林霉素、复方新诺明、红霉素及四环素最不敏感,对左旋氧氟沙星、氯霉素及万古霉素耐药性较低;大肠埃希菌、肺炎克雷伯杆菌对哌拉西林/他挫巴坦、亚胺培南、头孢替坦、厄他培南有较高敏感性。结论小儿呼吸道感染的细菌病原菌主要是革兰阳性菌,其次是革兰阴性菌,不同病原菌对抗菌药物的耐药性不同。

Objective To explore the distribution of bacterial pathogens and their resistance to antibiotics in children with respiratory tract infection.Methods A total of four hundred and two child patients with respiratory tract infection who were admitted to Dalian Central Hospital from March 2017 to December 2018 were selected.The sputum samples of all the child patients were cultured for the type of bacterial pathogens,and the drug sensitivity test was carried out.Results A total of one hundred and thirty eight strains of pathogenic bacteria were detected,and the positive rate was 34.33%.Among them,seventy-two strains were Gram-positive bacteria,accounting for 52.17%;sixty-three strains were Gram-negative bacteria,accounting for 45.65%;three strains of fungi accounted for 2.17%;Saphylococcus aureus,Escherichia coli,Streptococcus pneumoniae,Klebsiella pneumoniae and Haemophilus influenzae accounted for the top five pathogenic bacteria;Staphylococcus aureus was the least sensitive to erythromycin and penicillin.It was more sensitive to tetracycline,levofloxacin,gentamicin,trimethoprim and rifampicin,and was most sensitive to quinupridine/dalfopristin,Moxifloxacin,vancomycin,and linezolid;Streptococcus pneumoniae was the least sensitive to clindamycin,compound trimethoprim,erythromycin and tetracycline,and had low drug resistance to levofloxacin,chloramphenicol and vancomycin drug resistance;Escherichia coli and Klebsiella pneumoniae had higher sensitivity to piperacillin/tazobactam,imipenem,cefotetan and ertapenem.Conclusion The bacterial pathogens of respiratory infections in child patients are mainly Gram-positive bacteria,next to Gram-negative bacteria.Due to the different types of bacteria,the resistance to antibacterial drugs is also different.