某院儿内科41株小儿肺炎病原菌的分布特点及其耐药性分析

Analysis on Distribution Characteristics and Drug Resistance of 41 Strains of Children Pneumonia Pathogenic Bacteria in Pediatric Department of a Hospital

目的:分析医院儿内科小儿肺炎病原菌分布特点及其对抗菌药物的耐药情况。方法:选取医院2017年1月—2019年12月间收治的被确诊为肺炎的患儿105例病历资料,分析其患儿痰液标本中病原菌培养与检测结果,及其病原菌中不同菌株对抗菌药物的耐药情况。结果:105例小儿肺炎患儿的痰液样本中,检出病原菌41株;检出的致病菌有大肠埃希菌、肺炎克雷伯菌、肺炎链球菌、阴沟肠杆菌、金黄色葡萄球菌、流感嗜血杆菌、粪肠球菌、光滑假丝酵母、鲍曼不动杆菌和铜绿假单胞菌;其中革兰阴性菌26株(占63.41%)和革兰阳性杆菌13株(占31.71%);革兰阴性菌中主要病原菌对头孢菌素类抗菌药物的耐药率较高,革兰阳性菌中主要病原菌对青霉素及克林霉素的耐药率较高。结论:小儿肺炎主要为革兰阴性菌感染所致,临床治疗应及时采集患儿痰液标本检测其的病原菌的分布和药敏试验,根据药敏结果选择具有针对性的抗菌药物治疗,以提高其临床疗效与安全性。

Objective: To analyze the distribution characteristics and drug resistance to antibacterial agents of41 strains of children pneumonia pathogenic bacteria in pediatric department of a hospital. Methods: The medical records of 105 children diagnosed with pneumonia admitted to hospital from January 2017 to December 2019 were selected to analyze the culture and detection results of pathogenic bacteria in sputum samples of the children, as well as the drug resistance of different strains of pathogenic bacteria to antibiotics. Results: In the sputum samples from 105 children with pneumonia, 41 strains of pathogenic bacteria were detected. Of the pathogenic bacteria detected were Escherichia coli, Klebsiella pneumoniae,Streptococcus pneumoniae,Enterobacter cloacae, Staphylococcus aureus,Haemophilus influenzae, Enterococcus faecalis, Candida glabrata, Acinetobacter baumannii and Pseudomonas aeruginosa. Among them, there were 26 strains of Gram-negative bacteria(63.41%) and 13 strains of Gram-positive bacteria(31.71%). The resistance rates of the main pathogens in the Gram-negative bacteria to cephalosporins were higher, and the resistance rates of the main pathogens in the Gram-positive bacteria to penicillin and clindamycin were higher.Conclusion: Pediatric pneumonia is mainly caused by Gram-negative bacteria. In clinical treatment,sputum samples of children should be collected in time to detect the distribution of pathogenic bacteria and drug sensitivity test, and targeted antimicrobial drugs should be selected based on the drug sensitivity results to improve the clinical efficacy and safety.