住院患儿下呼吸道感染的常见病原菌分布及耐药性分析

Analysis of distribution and drug resistance of common pathogens of lower respiratory tract infections in hospitalized children

目的探讨广西柳州地区住院患儿下呼吸道感染常见病原菌的分布及耐药性,为临床治疗提供用药借鉴。方法回顾性选取2019年1月至12月间在广西柳州市工人医院儿科住院治疗的1703例下呼吸道感染患儿为研究对象,对所选取患儿进行痰培养或灌洗液培养及药敏试验,对分离出995例致病菌株病原菌进行构成比分析和耐药性分析。结果在分离出的995例致病菌株中,革兰阴性菌708株,占71.16%,以流感嗜血杆菌、卡他布兰汉菌为主;革兰阳性菌281株,占28.24%,以肺炎链球菌和金黄色葡萄球菌为主;真菌6株,占0.60%。主要革兰阴性菌流感嗜血杆菌、卡他布兰汉菌对氨苄西林和复方新诺明的耐药率均>50.00%,对氧氟沙星、氯霉素和四环素比较敏感,耐药率均在7.00%以下,两菌对头孢噻肟均未出现耐药。主要革兰阳性菌中,肺炎链球菌对克林霉素全部耐药,对红霉素、四环素耐药率较高,均在95.00%以上,未发现耐青霉素G、左旋氧氟沙星、万古霉素及利奈唑胺的菌株;金黄色葡萄球菌对青霉素G的耐药率较高,为90.00%,未发现耐万古霉素及利奈唑胺的菌株。结论下呼吸道感染患儿的常见病原菌以革兰阴性菌为主,临床用药时应根据药敏检测结果合理选用抗菌药物,减少耐药菌株出现。

Objective To investigate the distribution and drug resistance of common pathogens of lower respiratory tract infections in hospitalized children in Liuzhou,Guangxi,and to provide reference for clinical treatment.Methods Retrospectively selected 1703 children with lower respiratory tract infection who were hospitalized in the Pediatrics Department of Liuzhou Workers Hospital in Guangxi from January 2019 to December 2019 as the research objects.The selected children were subjected to sputum culture or lavage fluid culture and medicine.Sensitivity test,the composition ratio analysis and drug resistance analysis of the isolated pathogenic bacteria were carried out.Results A total of 995 pathogenic strains were isolated from 1703 hospitalized children,of which 708 strains of gram-negative bacteria,accounting for 71.16%,were mainly Haemophilus influenzae and Branhamella catarrhalis,and 281 strains of gram-positive bacteria,accounting for 28.24%,mainly Streptococcus pneumoniae and Staphylococcus aureus,6 fungi,accounting for 0.60%.The main gram-negative bacteria Haemophilus influenzae and Branhamella catarrhalis have a resistance rate of>50.00%to ampicillin and compound trimethoprim.They were more sensitive to ofloxacin,chloramphenicol and tetracycline,and their resistance rates were both below 7.00%,and neither of the two bacteria was resistant to cefotaxime.Among the main gram-positive bacteria,Streptococcus pneumoniae was all resistant to clindamycin,and the resistance rate to erythromycin and tetracycline was relatively high,above 95.00%,no strains resistant to penicillin G,levofloxacin,vancomycin and linezolid were found.Staphylococcus aureus had a higher resistance rate to penicillin G,90.00%,and no Vancomycin and linezolid resistant strains were found.Conclusion The common pathogens in children with lower respiratory tract infections are mainly gram-negative bacteria.In clinical medication,antibiotics should be rationally selected based on the results of drug susceptibility testing to reduce the emergence of drug-resistant strains.