某院102例重症细菌性肺炎患儿的病原菌分布及其耐药性分析

Analysis of Pathogens’ Distribution and Drug Resistance of 102 Children with Severe Bacterial Pneumonia in a Hospital

目的:探究医院102例重症细菌性肺炎患儿的病原菌分布及其耐药特点,为临床治疗重症肺炎提供参考。方法:选取2019年6月—2020年6月医院收治的102例重症细菌性肺炎患儿作为研究对象,在其确诊重症肺炎24 h内采集下呼吸道分泌物及2 m L静脉血进行细菌培养及药敏试验,统计患者病原菌的来源、分布,并分析主要革兰阴性菌、主要革兰阳性菌的耐药情况。结果:102例重症细菌性肺炎患儿标本检测出151株病原菌,其中痰液检出112株(占74.17%),血液检出73株(占48.34%);151株病原菌含92株革兰阴性菌、59株革兰阳性菌,分别占60.93%、39.07%;革兰阴性菌中前3位的分别为肺炎克雷伯菌36株(占23.84%)、大肠埃希菌18株(占11.92%)、鲍曼不动杆菌12株(占7.95%),革兰阳性菌前3位的分别为肺炎链球菌23株(占15.23%)、金黄色葡萄球菌16株(占10.60%)、溶血性链球菌12株(占7.95%);药敏结果显示,革兰阴性菌对亚胺培南、阿米卡星的耐药率低,肺炎克雷伯菌、大肠埃希菌对环丙沙星的耐药率较低;革兰阳性菌对利奈唑胺、万古霉素的耐药率低。结论:重症细菌性肺炎患儿的病原菌以革兰阴性菌为主,以肺炎克雷伯菌最为常见,检出病原菌对常见抗菌药物呈普遍耐药现象,临床应根据药敏试验结果制定适宜用药方案。

Objective: To explore the pathogens’ distribution and drug resistance of 102 children with severe bacterial pneumonia in a hospital, and to provide reference for the clinical treatment of severe pneumonia. Methods: 102 children with severe bacterial pneumonia admitted to hospital from June 2019 to June 2020 were selected as the research subjects.Lower respiratory tract secretions and 2 m L venous blood were collected within 24 hours of their diagnosis of severe pneumonia for bacterial culture and drug sensitivity test. The source and distribution of pathogenic bacteria of the patients were counted. The drug resistance of the main gram-negative bacteria and the main gram-positive bacteria was analyzed. Results: 151 strains of pathogenic bacteria were detected in 102 children with severe bacterial pneumonia, among whom 112 strains were detected in sputum(accounting for 74.17%), 73 strains were detected in blood(accounting for48.34%). A total of 92 Gram-negative and 59 Gram-positive strains were isolated from 151 pathogenic bacteria, accounting for 60.93% and 39.07%, respectively. Among gram-negative bacteria, 36 strains of Klebsiella pneumoniae(23.84%),18 strains of Escherichia coli(11.92%) and 12 strains of Acinetobacter baumannii(7.95%) accounted for the Top 3 proportion, respectively. The Top 3 proportion of gram-positive bacteria were 23 strains of Streptococcus pneumoniae(15.23%),16 strains of Staphylococcus aureus(10.60%) and 12 strains of Hemolytic Streptococcus(7.95%), respectively. The results of drug sensitivity showed that the resistance rate of Gram-negative bacteria to imipenem and amikacin was low. The drug resistance rate of Klebsiella pneumoniae and Escherichia coli to ciprofloxacin was low. The resistance rate of Grampositive bacteria to linezolid and vancomycin was low. Conclusion: Gram-negative bacteria were the main pathogens of severe bacterial pneumonia in children, and Klebsiella pneumoniae was the most common. Pathogenic bacteria were found to be resistant to common antibacterial drugs, and the appropriate drug use plan should be made based on the results of drug sensitivity test in clinical practice.