某院1265例支气管肺炎患儿痰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 Sputum Samples from 1265 Children with Bronchopneumonia in a Hospital

作　　者：张海峰 闫丽娜 翟磊 钟春燕 ZHANG Hai-feng;YAN Li-na;ZHAI Lei;ZHONG Chun-yan(Pingdingshan Medical Area,The People's Liberation Army No.989 Hospital,Pindingshan Henan 467000,China;Guangzhou Xinhua University,Guangzhou 510520,China)

机构地区：[1]解放军第九八九医院平顶山医疗区,河南平顶山467000 [2]广州新华学院,广州510520

出　　处：《抗感染药学》2022年第12期1636-1640,共5页Anti-infection Pharmacy

基　　金：广州新华学院校级重点学科建设(编号:2020XZD03);2019年广东省普通高校青年创新人才类项目-自然科学(编号:2019KQNCX208);2022年度民办高校教育研究项目(编号:GMG2022059);广州新华学院2021年校级教学质量与教学改革工程项目(编号:2021J049);广州新华学院2021年校级教学质量与教学改革工程项目(编号:2021XN001);广州新华学院2020年校级教学质量与教学改革工程项目(编号:2020J063);广州新华学院2020年度教职工校级科研项目(编号:2020KYYB05);2021年第二批产学合作协同育人项目(编号:202102072053)

摘　　要：目的:分析医院支气管肺炎患儿痰标本中病原菌的分布与耐药情况,为临床该类患者的抗菌药物合理使用提供参考。方法:选取2016年8月—2021年8月解放军第九八九医院儿科收治的1265例支气管肺炎患儿作为研究对象,采集患儿痰标本行病原菌培养与药敏试验,分析患儿感染的病原学特征。结果:1265例儿童支气管肺炎患儿痰标本中检出1598株病原菌,其中革兰阴性菌937株(占58.64%,以大肠埃希菌、肺炎克雷伯菌、流感嗜血杆菌为主)、革兰阳性菌647株(占40.49%,以肺炎链球菌、金黄色葡萄球菌、化脓性链球菌为主)和真菌14株(占0.88%);大肠埃希菌和肺炎克雷伯菌在春、夏、秋、冬四季中检出数较为稳定,而金黄色葡萄球菌和肺炎链球菌则在冬、春季节检出较多,夏、秋季节检出较少;药敏结果显示,金黄色葡萄球菌、肺炎链球菌和化脓性链球菌对万古霉素和利奈唑胺的耐药率为0.00%,对头孢曲松、头孢噻肟的耐药率相对较低(<10.00%),对红霉素、克拉霉素、克林霉素的耐药率均较高(>60.00%);流感嗜血杆菌对所有所试抗菌药物的耐药率均较低(<15.00%),大肠埃希菌和肺炎克雷伯菌对亚胺培南、美罗培南、头孢哌酮-舒巴坦钠、哌拉西林-他唑巴坦钠、头孢他啶、头孢西丁的耐药率较低(<30.00%)。结论:医院支气管肺炎患儿的致病菌主要有大肠埃希菌、肺炎克雷伯菌、流感嗜血杆菌、肺炎链球菌、金黄色葡萄球菌和化脓性链球菌,其对抗菌药物的耐药特点各有差异,临床在制定治疗方案前应尽量进行病原菌培养与药敏试验,以指导临床医生合理选用抗菌药物,确保抗感染治疗的效果。Objective:To investigate the distribution and drug resistance of pathogenic bacteria in sputum samples from children with bronchopneumonia in the hospital,so as to provide reference for the rational use of antibacterial drugs in such patients in the clinic.Methods:A total of 1265 children with bronchopneumonia admitted to the Department of Pediatrics of the People's Liberation Army No.989 Hospital from August 2016 to August 2021 were chosen as the subjects.Their sputum samples were collected for pathogen culture and antimicrobial susceptibility testing to analyze the etiological characteristics of infection in children.Results:Among the sputum samples of 1265 children with bronchopneumonia,1598 strains of pathogenic bacteria were detected,including 937 strains of Gram-negative bacteria(58.64%,mainly Escherichia coli,Klebsiella pneumoniae and Haemophilus influenzae),647 strains of Gram-positive bacteria(40.49%,mainly Streptococcus pneumoniae,Staphylococcus aureus and Streptococcus pyogenes)and 14 strains of fungi(0.88%);the detected number of Escherichia coli and Klebsiella pneumoniae in spring,summer,autumn and winter was relatively stable,while the detected number of Staphylococcus aureus and Streptococcus pneumoniae was more in winter and spring,and less in summer and autumn.The antimicrobial susceptibility testing showed that,the resistance rates of Staphylococcus aureus,Streptococcus pneumoniae and Streptococcus pyogenes to vancomycin and linezolid were 0.00%,and their resistance rates to ceftriaxone and cefotaxime were relatively low(less than 10.00%),while their resistance rates to erythromycin,clarithromycin and clindamycin were high(more than 60.00%);the resistance rate of Haemophilus influenzae to all tested antibacterial drugs was low(less than 15.00%).The resistance rates of Escherichia coli and Klebsiella pneumoniae to imipenem,meropenem,cefoperazone-sulbactam sodium,piperacillintazobactam sodium,ceftazidime and cefoxitin were low(less than 30.00%).Conclusion:The pathogenic bacteria in children with b

关 键 词：儿童支气管肺炎 病原菌分布 耐药特点 

分 类 号：R446.5[医药卫生—诊断学] R725.6[医药卫生—临床医学]