某院肺部感染儿童肺泡灌洗液标本中病原菌的分布与耐药性分析

Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Alveolar Lavage Fluid Samples of Children with Pulmonary Infection in a Hospital

目的:分析医院肺部感染儿童肺泡灌洗液标本中病原菌的分布与耐药特点,为该类患者抗菌药物的使用提供依据。方法:选取2021年1月—2022年1月开封市儿童医院呼吸科收治的80例肺部感染患儿作为研究对象,分析患儿肺泡灌洗液标本中病原菌的分布与耐药情况。结果:80例肺部感染患儿肺泡灌洗液标本中共检出97株病原菌,其中革兰阳性菌19株(占19.58%,以金黄色葡萄球菌为主)、革兰阴性菌71株(占73.20%,以鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌为主)和真菌7株(占7.22%,以白假丝酵母为主);药敏结果显示,金黄色葡萄球菌对磷霉素、复方磺胺甲噁唑、利奈唑胺、万古霉素、替考拉宁的耐药率均为0.00%;鲍曼不动杆菌对阿米卡星、磷霉素、多黏菌素的耐药率较低(<20.00%);肺炎克雷伯菌对环丙沙星、阿米卡星、头孢哌酮-舒巴坦钠、哌拉西林-他唑巴坦钠、磷霉素、厄他培南、亚胺培南、美罗培南、多黏菌素的耐药率较低(<15.00%);铜绿假单胞菌对庆大霉素、环丙沙星、阿米卡星、磷霉素、多黏菌素的耐药率较低(<10.00%);7株真菌对临床常用抗真菌药物均较为敏感。结论:患儿肺部感染病原菌以金黄色葡萄球菌、鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌为主,临床在制定治疗方案时应尽量根据病原菌的分布及其耐药特点合理选用抗菌药物,以确保治疗的有效性。

Objective:To analyze the distribution and drug resistance characteristics of pathogenic bacteria in alveolar lavage fluid samples of children with pulmonary infection in the hospital and provide basis for the use of antibacterial drugs in such patients.Methods:80 children with pulmonary infection who were admitted to the Department of Respiratory Medicine of Kaifeng Children's Hospital from January 2021 to January 2022 were selected as the research subjects,and the distribution and drug resistance of pathogenic bacteria in the children's alveolar lavage fluid samples were analyzed.Results:A total of 97 strains of pathogenic bacteria were detected in the alveolar lavage fluid samples of the 80 children with pulmonary infection,including 19 strains of Gram-positive bacteria(19.58%,mainly Staphylococcus aureus)and 71 strains of Gram-negative bacteria(73.20%,mainly Acinetobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa)and 7 strains of fungi(7.22%,mainly Candida albicans).The drug susceptibility test results showed that the resistance rates of Staphylococcus aureus to fosfomycin,compound sulfamethoxazole,linezolid,vancomycin and teicoplanin were 0.00%;the resistance rates of Acinetobacter baumannii to amikacin,fosfomycin and polymyxin were low(less than 20.00%);the resistance rates of Klebsiella pneumoniae to ciprofloxacin,amikacin,cefoperazone-sulbactam sodium,piperacillin-tazobactam sodium,fosfomycin,ertapenem,imipenem,meropenem and polymyxin were low(less than 15.00%);the resistance rates of Pseudomonas aeruginosa to gentamicin,ciprofloxacin,amikacin,fosfomycin and polymyxin were low(less than 10.00%);7 strains of fungi were susceptible to commonly used antifungal drugs in the clinics.Conclusion:Staphylococcus aureus,Acinetobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa are the main pathogenic bacteria of pulmonary infection in children.Clinically,the anti‐bacterial drugs should be chosen rationally based on the distribution of pathogenic bacteria and their drug resistance characteristics when a treatment regimen is formulated to ensure the effectiveness of the treatment.