百日咳患儿相关病原菌药物敏感情况及其影响因素分析

Analysis of drug sensitivity of pertussis related pathogens in children and its influencing factors

目的:探究儿童百日咳疾病病原菌的药物敏感性,以及导致百日咳发生的影响因素。方法:将芜湖市第一人民医院儿科收治的96例确诊为百日咳的患儿设为感染组,对其进行过病原菌药敏试验。另选择同科室同期门诊就诊的96例非百日咳患儿设为非感染组。分析两组临床资料,探究可能导致儿童发生百日咳的影响因素。结果:96例鼻咽或咽分泌物样本中,共分离培养出病原菌119例,其中百日咳鲍特菌检出90例(75.63 %),副百日咳鲍特菌检出25例(21.01 %),支气管败血鲍特菌检出4例(3.36 %)。三种百日咳病原菌对青霉素类和头孢菌素类抗生素敏感性较高,对大环内酯类和林克酰胺类抗生素敏感性中等。多因素分析结果显示,年龄≤3月龄、未接种和无全程接种百日咳疫苗、儿童有其他呼吸系统疾病和通风条件不佳是导致的危险因素。结论:百日咳病原菌逐渐降低对大环内酯类抗菌药物敏感性,对青霉素类和头孢菌素类抗菌药物敏感性较高。儿童及时接种疫苗能有效降低百日咳的发生风险。

Objective To investigate the antimicrobial susceptibility and influence factors of pertussis in children.Methods 96 children diagnosed with pertussis admitted to the Department of Pediatrics of Wuhu NO.1 People’s Hospital were divided into infection group.We’ve tested it for pathogen susceptibility.In addition,96 non-pertussis children in the same department were selected as the non-infection group.The clinical data of the two groups were retrospectively analyzed to analyze the factors that may lead to pertussis in children.Results A total of 119 cases of pathogenic bacteria were isolated and cultured from 96 nasopharyngeal or pharyngeal secretions,including 90 cases (75.63 %) of Bordetella pertussis,25 cases (21.1 %) of paraplegia pertussis and 4 cases (3.36 %) of bronchial septicemia.The three pertussis pathogens had high sensitivity to penicillins and cephalosporins,but moderate sensitivity to macrolides and linkamide.Multivariate analysis showed that age ≤ 3 months,not vaccinated or not fully vaccinated against pertussis,children with other respiratory diseases,poor ventilation conditions and low per capita disposable income were the risk factors.Conclusion Pertussis pathogenic bacteria gradually reduce the sensitivity to macrolides antibacterial drugs.It is highly sensitive to penicillin and cephalosporins.Timely vaccination of children can effectively reduce the risk of pertussis.