哮喘患儿急性呼吸道感染及病原谱分析

Acute respiratory tract infection and pathogen spectrum analysis in children with asthma

目的针对哮喘患儿呼吸道感染进行病原菌流行病学特征分析讨论,以利预防和诊治。方法研究选取四川省资阳市第一人民医院哮喘并见呼吸道感染的住院患儿共206例。对比两组患儿病原菌分布及耐药性之间的潜在关联。结果上呼吸道感染患儿131例患者共送检血液标本检出病原菌共167株,下呼吸道感染患儿75例患者共送检血液标本检出病原菌共262株,哮喘并急性下呼吸道感染患儿中<5岁女性患儿病原菌分布革兰氏阳性菌感染高于革兰氏阴性菌,其中以表皮葡萄球菌所占比例最高(P<0.05);革兰氏阳性菌对青霉素、红霉素及克拉霉素的耐药率较高;革兰氏阴性菌对氨苄西林、头孢唑林及头孢呋辛的耐药率较高;上呼吸道感染和下呼吸道感染患儿分布特征均表现一致。结论儿科哮喘患儿并见呼吸道感染,病原菌主要以革兰氏阴性菌为主,且耐药率较高。但<5岁的低龄女患儿革兰氏阳性菌(主要为表皮葡萄球菌)感染高于革兰氏阴性菌,值得特别关注。

Objective To analyze the epidemiological characteristics of Pathogenic bacteria for respiratory tract infection in children with asthma to facilitate the prevention,diagnosis,and treatment.Methods Among 206 hospitalized children with asthma and respiratory tract infection from January 2019 to December 2021 were selected for analysis in this study,including 131 cases with upper respiratory tract infection and 75 cases with lower respiratory tract infection.The potential correlation between the distribution of Pathogenic bacteria and drug resistance was analyzed and compared between the two groups.Results A total of 167 strains of Pathogenic bacteria were detected in 131 children with upper respiratory tract infection,and 262 strains were detected in 75 children with lower respiratory tract infection.The distribution characteristics of Pathogenic bacteria in children with asthma and acute upper respiratory tract infection were consistent with the total distribution characteristics.Among children with asthma and acute lower respiratory tract infection,the infection of Gram-positive bacteria was higher than that of Gram-negative bacteria in female children younger than 5 years old,and the proportion of staphylococcus epidermidis was the highest(P<0.05),The distribution characteristics of Pathogenic bacteria in children of other ages and sexes were consistent with the total distribution characteristics.The resistance rate of Gram-positive bacteria to penicillin,erythromycin and clarithromycin was high,while the resistance rate of Gram-negative bacteria to ampicillin,cefazolin and cefuroxime was high.The distribution characteristics of Pathogenic bacteria in children with upper respiratory tract infection and lower respiratory tract infection were consistent.Conclusion In children with pediatric asthma and respiratory tract infection,the main pathogens are Gram-negative bacteria,and the drug resistance rate is high.However,the infection of Gram-positive bacteria(mainly Staphylococcus epidermidis)in young female children under 5 years old is higher than that of Gram-negative bacteria in other children,which deserves special attention.