2016~2018年聊城市部分儿童社区获得性肺炎患者的病原体分布及耐药性分析

Analysis on distribution and drug resistance of pathogens in children with community-acquired pneumonia,Liaocheng city,2016-2018

目的了解聊城市儿童社区获得性肺炎(CAP)患者的病原谱构成及主要病原菌的耐药情况,为临床治疗提供参考依据。方法选取2016年7月至2018年12月确诊的670例社区获得性肺炎患儿为研究对象,对其呼吸道分泌物进行细菌培养,呼吸道8种病毒及3种非典型病原体进行检测,并对结果进行分析。结果 670例病例中有425例病原学阳性(63.43%)。共检出718株病原,其中细菌208株(28.97%),主要包括流感嗜血杆菌、肺炎链球菌、卡他莫拉菌、肺炎克雷伯菌等。病毒检出261株(36.35%),主要包括呼吸道合胞病毒、副流感病毒、鼻病毒等。非典型病原体主要检出肺炎支原体(34.54%)。混合感染率达到43.73%,占病原阳性患儿的68.94%,混合感染以支原体和病毒混合感染为主,其次是细菌和支原体混合感染较多。主要的革兰阳性菌对青霉素、红霉素、复方新诺明等均有较高的耐药性;主要的革兰阴性菌对复方新诺明有较高的耐药性,对亚胺培南均有很高的敏感性。结论聊城市儿童社区获得性肺炎患者的主要病原是肺炎支原体和病毒,呼吸道合胞病毒为主要病毒病原,且肺炎支原体混合感染率较高。

Objective To understand the pathogen spectrum and drug resistance of main pathogens in children with community-acquired pneumonia(CAP) in Liaocheng city, so as to provide reference for clinical treatment. Methods A total of 670 children with CAP were selected from July 2016 to December 2018.Respiratory secretions were collected to detect bacteria, 8 viruses and 3 atypical pathogens, and the results were analyzed. Results There were 425 pathogens were detected among the 670 samples(63.43%).A total of 718 strains of pathogens were detected, in which 208 strains of bacteria(28.97%) mainly included haemophilus influenzae streptococcus pneumoniae,moraxella catarrhalis,klebsiella pneumoniae.There were 261 strains of the virus(36.35%) detected, mainly included human respiratory syncytial virus, parainfluenza virus and rhino virus.Atypical pathogens were mainly mycoplasma pneumoniae(34.54%).The mixed infection rate reached 43.73%,accounting for 68.94% of pathogen-positive children.The mixed infection was mainly caused by mycoplasma and virus, followed by bacteria and mycoplasma.The main gram-positive bacteria were resistant to penicillin,erythromycin and paediatric compound sulfamethoxazole.The main gram-negative bacteria had high resistance to paediatric compound sulfamethoxazole and high sensitivity to imipenem. Conclusion The main pathogens of CAP in children in Liaocheng city are mycoplasma pneumoniae and viruses.Human respiratory syncytial virus is the main viral pathogen, and the mixed infection rate of mycoplasma pneumoniae is high.In the empirical.