反复上呼吸道感染患儿病原菌分布及耐药性分析

Analysis of pathogen distribution and drug resistance in children with recurrent upper respiratory tract infection

目的:分析反复上呼吸道感染患儿病原菌分布及耐药性。方法:选取2022年1月至2023年1月该院收治的120例反复上呼吸道感染患儿进行横断面研究,通过细菌病原菌类型培养,并进行药敏试验,统计反复上呼吸道感染患儿病原菌分布情况,分析主要革兰阴、阳性菌耐药性。结果:120例患儿共检出161株病原菌,其中革兰阴性菌114株,占70.81%,肺炎克雷伯杆菌为主要革兰阴性致病菌(29.81%);革兰阳性菌47株,占29.19%,金黄色葡萄球菌为主要革兰阳性致病菌(19.25%)。肺炎克雷伯菌对氨苄西林的耐药性最高(100.00%),对复方新诺明、头孢唑啉、头孢曲松、氨苄西林/舒巴坦、庆大霉素、头孢他啶、妥布霉素的耐药性较低(均<20.00%),对环丙沙星、左氧氟沙星、阿米卡星、厄他培南、哌拉西林/他唑巴坦、头孢吡肟、头孢替坦、亚胺培南不耐药(均为0)。大肠埃希菌对氨苄西林的耐药性最高(82.93%),对复方新诺明、头孢唑啉、头孢曲松、氨苄西林/舒巴坦、庆大霉素、环丙沙星、左氧氟沙星耐药性较高,对妥布霉素、阿米卡星的耐药性较低(均<10.00%),对哌拉西林/他唑巴坦、头孢吡肟、头孢替坦、亚胺培南、厄他培南不耐药(均为0)。金黄色葡萄球菌对苯唑西林、红霉素的耐药性最高(均为70.97%),对阿莫西林、四环素、克林霉素、复方磺胺甲恶唑、利福平、左氧氟沙星、氨苄西林、氯霉素、庆大霉素、青霉素、头孢呋辛、头孢噻吩的耐药性较高,对亚胺培南和头孢噻肟的耐药性较低,对万古霉素不耐药(为0)。结论:反复上呼吸道感染患儿主要病原菌为革兰阴性肺炎克雷伯杆菌和革兰阳性金黄色葡萄球菌,其中肺炎克雷伯菌对氨苄西林耐药性为100.00%,金黄色葡萄球菌对苯唑西林、红霉素耐药性均为70.97%,临床应合理选择抗菌药治疗。

Objective:To analyze pathogen distribution and drug resistance in children with recurrent upper respiratory tract infection.Methods:A cross-sectional study was conducted on 120 children with recurrent upper respiratory tract infection admitted to the hospital from January 2022 to January 2023.The bacterial pathogen culture and the drug sensitivity test were performed.The distribution of pathogenic bacteria in these children was statistically analyzed.The drug resistance of main gram-negative and positive bacteria was analyzed.Results:161 strains of pathogenic bacteria were detected in the 120 children,including 114 strains of Gram-negative bacteria,accounting for 70.81%,Klebsiella pneumoniae is the main gram-negative pathogen(29.81%);there were 47 strains of gram-positive bacteria,accounting for 29.19%,of which Staphylococcus aureus is the main gram positive pathogen(19.25%).Klebsiella pneumoniae had the highest resistance to Ampicillin(100.00%),and had low resistance to compound Sulfamethoxazole,Cefazolin,Ceftriaxone,Ampicillin/Sulbactam,Gentamicin,Ceftazidime,and Tobramycin(all<20.00%);and it was not resistant to Ciprofloxacin,Levofloxacin,Amikacin,Ertapenem,Piperacillin/Tazobactam,Cefepime,Cefotetan,and Imipenem(all 0).Escherichia coli had the highest resistance to Ampicillin(82.93%),had higher resistance to compound Sulfamethoxazole,Cefazolin,Ceftriaxone,Ampicillin/Sulbactam,Gentamicin,Ciprofloxacin and Levofloxacin,and had lower resistance to Tobramycin and Amikacin(all<10.00%);and it was not resistant to Piperacillin/Tazobactam,Cefepime,Cefotetan,Imipenem and Ertapenem(all 0).Staphylococcus aureus had the highest resistance to Oxacillin and Erythromycin,both of which were 70.97%;had higher resistance to Amoxicillin,Tetracycline,Clindamycin,compound Sulfamethoxazole,Rifampicin,Levofloxacin,Ampicillin,Chloramphenicol,Gentamicin,Penicillin,Cefuroxime and Cephalothin;and had lower resistance to Imipenem and Cefotaxime and no resistance to Vancomycin(0).Conclusions:The main pathogenic bacteria in the children with recurrent upper respiratory tract infection are Gram-negative Klebsiella pneumoniae and Gram-positive Staphylococcus aureus.The resistance of Klebsiella pneumoniae to Ampicillin is 100.00%,and the resistance of Staphylococcus aureus to Oxacillin and Erythromycin is 70.97%.Therefore,antibiotic treatment should be reasonably selected in the clinical practice.