某院住院患儿下呼吸道感染病原菌分布及耐药性调查

Investigation on the distribution and drug resistance of pathogens in hospitalized children with lower respiratory tract infection

目的研究某院住院患儿下呼吸道感染病原菌分布及耐药性,为指导临床合理使用抗菌药物提供科学依据。方法通过细菌分离培养和药敏试验方法,对某院住院患儿下呼吸道感染送检病原学标本进行检测和分析。结果568例下呼吸道感染患儿痰培养阳性172例,阳性率为30.3%,检出革兰阴性菌124株,占72.1%,其中以大肠埃希菌最常见,占23.2%;革兰阳性菌48株,占27.9%,以金黄色葡萄球菌、肺炎链球菌多见,分别占11.0%、6.4%;真菌8株,占4.7%。不同年龄组病原菌的检出率比较差异有统计学意义(P<0.05)。主要革兰阴性菌对氨苄西林耐药率最高,检测出4株碳青霉烯耐药的肺炎克雷伯菌,主要革兰阳性球菌对苯唑西林、红霉素耐药严重,对万古霉素敏感。结论住院患儿下呼吸道感染病原菌以革兰阴性菌为主,不同细菌对抗菌药物的耐药性不同,根据药物敏感试验合理选择抗菌药物,对下呼吸道感染耐药菌株的减少有重要的临床意义。

Objective To study the distribution and drug resistance of pathogens with lower respiratory tract infections in hospitalized children to provide scientific basis for guiding the rational use of antimicrobial drugs.Methods To detect and analyze the etiology specimens of lower respiratory tract infection in hospitalized children by bacterial isolation,culture and drug sensitivity test.Results The sputum culture of 568 children with lower respiratory tract infections were positive in 172 cases,the positive rate was 30.3%,and 124 were gram-negative bacteria,accounting for 72.1%,of which the most common was Escherichia coli,accounting for 23.2%;of which 48 were gram-positive bacteria,accounted for 27.9%,with Staphylococcus aureus and Streptococcus pneumoniae the most common,respectively accounting for 11.0%and 6.4%;8 strains of Fungal were detected,account for 4.7%.The difference in the detection rate of pathogens in different age groups is statistically significant(P<0.05).The main gram-negative bacteria had the highest rate of resistance to ampicillin,and four strains of Klebsiella pneumoniad were detected.The main gram-positive cocci were severely resistant to benzoxacin and erythromycin,and were sensitive to vancomycin.Conclusion The main pathogenic bacteria with lower respiratory tract infections in inpatient children are gram-negative bacteria,and the antimicrobial drug resistance of different bacteria is different.The reasonable selection of antimicrobial drugs according to drug sensitivity test has important clinical significance for the reduction of drug-resistant strains of lower respiratory tract infection.