378例儿童呼吸道感染流行病学调查及耐药性分析

Epidemiological investigation and pathogens analysis of respiratory tract infection in the 378 children

目的了解儿童呼吸道感染流行病学特征,分析病原体耐药性。方法选取2021年7月-2022年7月三门峡市中心医院收治的378例呼吸道感染儿童作为研究对象,统计分析呼吸道感染流行病学特征、病原体类型以及病原体耐药情况。结果378例呼吸道感染儿童中,共检出病原体99株,检出率为26.19%。其中革兰阳性菌38株(38.38%),主要为肺炎链球菌和金黄色葡萄球菌。革兰阴性菌52株(52.53%),主要为肺炎克雷伯菌、流感嗜血杆菌和大肠埃希菌;真菌2株(2.02%),病毒7株(7.07%);儿童呼吸道感染病原体分布在年龄、发病季节方面差异有统计学意义(χ^(2)=14.015、18.483,P均<0.05);药敏分析显示,主要革兰阳性菌对青霉素、红霉素、克林霉素的耐药率较高(50%以上),对万古霉素、美罗培南较敏感。主要革兰阴性菌对氨卡西林的耐药率较高,多数对亚胺培南、美罗培南、左氧氟沙星较敏感。结论儿童呼吸道感染以肺炎链球菌、金黄色葡萄球菌、肺炎克雷伯菌、流感嗜血杆菌、大肠埃希菌为主,病原体分布在年龄和季节上存在明显差异。

Objective To understand the epidemiological characteristics of respiratory tract infections in children and analyze pathogen resistance.Methods A total of 378 children with respiratory tract infection were enrolled as the research objects in Sanmenxia Central Hospital between July 2021 and July 2022.The epidemiological characteristics,pathogen types and pathogens resistance of respiratory tract infection were statistically analyzed.Results In the 378 children with respiratory tract infection,there were 99 strains of pathogens,with detection rate of 26.19%.There were 38 strains of gram⁃positive bacteria(38.38%,mainly on Streptococcus pneumoniae and Staphylococcus aureus),52 strains of gram⁃negative bacteria(52.53%,mainly on Klebsiella pneumoniae,Haemophilus influenzae and Escherichia coli),2 strains of fungi(2.02%)and 7 strains of viruses(7.07%).There were significant differences in pathogens distribution of respiratory tract infection among children with different ages and onset seasons(χ^(2)=14.015,18.483;all P<0.05).The drug sensitivity analysis showed that resistance rates of the main gram⁃positive bacteria were high to penicillin,erythromycin and clindamycin(>50%),and they were sensitive to vancomycin and meropenem.The resistance rate of the main gram⁃negative bacteria was high to ampicillin,and most of them were sensitive to imipenem,meropenem and levofloxacin.Conclusions Streptococcus pneumoniae,Staphylococcus aureus,Klebsiella pneumoniae,Haemophilus influenzae and Escherichia coli were the main pathogens of respiratory tract infection in children.There were significant differences in the distribution of pathogens among children with different ages and onset seasons.