小儿呼吸道感染的抗生素应用现状及病原菌耐药率分析

Analysis of application status of antibiotics and drug resistance rate of pathogenic bacteria in children with respiratory tract infection

目的分析小儿呼吸道感染的抗生素应用现状及病原菌耐药率。方法选取2019年3月至2021年1月本院收治的450例呼吸道感染患儿为研究对象,提取痰样本,行细菌培养及药敏试验,统计结果并进行分析。结果本研究共分离出病原菌343株,其中革兰阴性菌284株,革兰阳性菌44株,其他15株。排名前5位的病原菌依次为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌、鲍曼不动杆菌。所用抗生素以青霉素类、头孢类、大环内酯类、氨基糖苷类为主,联用2种及以上抗生素患儿共125例,占27.78%。革兰阴性菌对阿莫西林/克拉维酸、哌拉西林/他唑巴坦、氨苄西林、阿米卡星高度耐药,但对头孢哌酮、头孢西丁、亚胺培南具有一定的敏感性。金黄色葡萄球菌、肺炎链球菌对青霉素G、苯唑西林、庆大霉素、红霉素具有一定的耐药性,但对万古霉素高度敏感。结论在小儿呼吸道感染的治疗中,不少病原菌已对抗生素产生耐药性,临床应重视病原菌的跟踪与检测工作,掌握其耐药变迁,选用敏感性较强的抗生素进行治疗,避免抗生素滥用情况的发生。

Objective To analyze the application status of antibiotics and drug resistance rate of pathogenic bacteria in children with respiratory tract infection.Methods A total of 450 children with respiratory tract infection treated in our hospital from March 2019 to January 2021 were selected as the research objects,sputum samples were extracted,bacterial culture and drug sensitivity test were carried out,and the results were counted and analyzed.Results A total of 343 strains of pathogenic bacteria were isolated,including 284 Gram-negative bacteria,44 Gram-positive bacteria and 15 others.The top 5 pathogenic bacteria were Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,Staphylococcus aureus and Acinetobacter baumannii.Penicillins,cephalosporins,macrolides and aminoglycosides were the main antibiotics used in children,and 125 children were combined with two or more antibiotics,accounting for 27.78%.Gram-negative bacteria were highly resistant to amoxicillin/clavulanic acid,piperacillin/tazobactam,ampicillin and amikacin,but they were sensitive to cefoperazone,cefoxitin and imipenem.Staphylococcus aureus and Streptococcus pneumoniae had certain resistance to penicillin G,oxacillin,gentamicin and erythromycin,but they were highly sensitive to vancomycin.Conclusion In the treatment of respiratory tract infection in children,many pathogenic bacteria have developed resistance to antibiotics.Clinical should pay attention to the tracking and detection of pathogenic bacteria,master the changes of drug resistance,and select highly sensitive antibiotics for treatment to avoid the occurrence of antibiotic abuse.