2021—2022年某院支气管肺炎患儿痰培养病原菌分布、耐药性监测分析

Analysis of the distribution and drug resistance monitoring of pathogenic bacteria in sputum culture of children with bronchopneumonia in a certain hospital from 2021 to 2022

目的探讨2021—2022年某院支气管肺炎患儿痰培养病原菌分布和耐药情况,并对临床合理性用药提供相应的参考。方法选取2021年10月至2022年12月儿科收治的1590例支气管肺炎患儿作为研究对象,对所选患儿均行痰培养试验,分析其痰培养病原菌分布和耐药情况。结果1590例患儿中痰培养阳性306例,阳性率为19.25%。分离病原菌346株,其中包括171株革兰氏阴性菌,占比49.42%,以流感嗜血杆菌(84株,占比24.28%)为主;157株革兰氏阳性菌,占比45.38%,以金黄色葡萄球菌(54株,占比15.61%)与肺炎链球菌(96株,占比27.75%)为主;18株真菌,占比5.20%,以白色假丝酵母菌(11株,占比3.18%)为主。流感嗜血杆菌对氨苄西林、头孢克洛、头孢呋辛、复方新诺明的耐药率较高,分别为92.86%、92.86%、85.71%、85.71%;对头孢曲松、左氧氟沙星、美罗培南、阿奇霉素均敏感。金黄色葡萄球菌对青霉素的耐药率最高,为87.04%;对庆大霉素、左氧氟沙星、莫西沙星的耐药率较低,分别为3.70%、7.41%、5.56%。肺炎链球菌对红霉素、四环素、复方新诺明的耐药率均较高,分别为100.00%、93.75%、68.75%;对青霉素、利奈唑胺、万古霉素均敏感。结论流感嗜血杆菌、金黄色葡萄球菌和肺炎链球菌是2021—2022年某医院小儿支气管肺炎的主要病原菌,其药敏结果可指导临床合理用药。

Objective To investigate the distribution and drug resistance of pathogenic bacteria in sputum culture of children with bronchopneumonia in a certain hospital from 2021 to 2022,and to provide corresponding references for clinical rational drug use.Methods A total of 1590 children with bronchopneumonia admitted in the pediatric department from October 2021 to December 2022 were selected as the research objects,sputum culture tests were performed on all children,and the distribution and drug resistance of pathogenic bacteria in sputum culture were analyzed.Results Among 1590 children,306 cases were positive in sputum culture,and the positive rate was 19.25%.A total of 346 strains of pathogenic bacteria were isolated,of which 171 strains were Gram-negative bacteria,accounting for 49.42%,mainly Haemophilus influenzae(84 strains,accounting for 24.28%);157 strains were Gram-positive bacteria,accounting for 45.38%,mainly Staphylococcus aureus(54 strains,accounting for 15.61%)and Streptococcus pneumoniae(96 strains,accounting for 27.75%);18 strains were fungi,accounting for 5.20%,mainly Candida albicans(11 strains,accounting for 3.18%).Haemophilus influenzae had high drug resistance rate to ampicillin,cefaclor,cefuroxime and cotrimoxazole,with 92.86%,92.86%,85.71%and 85.71%,respectively;it was sensitive to ceftriaxone,levofloxacin,azithromycin,meropenem.Staphylococcus aureus had the highest drug resistance rate to penicillin,with 87.04%,and the drug resistance rate to gentamicin,levofloxacin and moxifloxacin were relatively low,with 3.70%,7.41%and 5.56%,respectively.Streptococcus pneumoniae had high drug resistance rate to erythromycin,tetracycline and cotrimoxazole,with 100.00%,93.75%and 68.75%,respectively;it was sensitive to penicillin,linezolid and vancomycin.Conclusion Haemophilus influenzae,Staphylococcus aureus and Streptococcus pneumoniae are the main pathogenic bacteria causing pediatric bronchopneumonia in a certain hospital from 2021 to 2022,and their drug sensitivity results can guide clinical rational drug use.