儿童下呼吸道感染病原学检测及抗菌药耐药性分析  

Pathogenic Bacteria and Their Antibiotic Resistance of Lower Respiratory Tract Infection in Childhood

作　　者：仇济韵[1] 

机构地区：[1]湖南省人民医院药剂科,长沙410002

出　　处：《中国药师》2008年第6期673-675,共3页China Pharmacist

摘　　要：目的:了解本地区小儿呼吸道感染常见病原菌及其对常用抗菌药的耐药性。为临床药物治疗提供有价值的参考。方法:对2006年7月～2007年7月住院的下呼吸道感染患儿常规进行深部痰培养,并做细菌株鉴定和药敏试验。结果:下呼吸道感染患儿共3527例,共培养出病原菌1056株,阳性率为29.9%,其中G^-菌751株(71.1%),G^+菌207株(19.6%),真菌91株(8.6%)。最常见的病原菌为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、鲍曼不动杆菌。分离率分别为:23.9%,21.6%,8.6%,8.0%,6.0%。肺炎克雷伯菌和大肠埃希菌产超广谱β-内酰胺酶的百分率分别为45.2%、41.7%,较敏感的抗菌药为亚胺培南、环丙沙星、阿米卡星。G^-菌(肺炎克雷伯菌、大肠埃希菌、鲍曼不分杆菌、铜绿假单胞菌)对氨苄西林、头孢唑林显示高耐药性。金黄色葡萄球菌中耐甲氧西林金葡萄占14.3%,金葡萄对氯霉素、万古霉素、利福平敏感。阴沟肠杆菌虽然分离率不高,但存在相当高的耐药率。结论:对下呼吸道感染患儿需及早做细菌学检测,合理选用抗菌药。Objective： To study the pathogenic bacteria and drug resistance of the pathogenic bacteria in children with lower respiratory tract infection（LRTI）. Method： Sputum speciments for bacterial were collected in sterile tubes from all of the children with LRTI who had been admitted to the Hunan provincial people＇s Hospital between June 2006 and June 2007. Bacteria were isolated and identified and antibiotic resistance was detected. Result： In 3527 cases, 1056 strains were obtained from lower respiratory tract sputum sampies of Children （29.9 % ） , gram-negative bacterium in 751 strains （71.1% ） , gram-positive bacterium in 207 strains （ 19.6 % ）. Fungus in 91 strains （8.6 % ）. K. pneumoniae was the most common （ 252 strains）, followed by E. coli （ 228 strains）, P. aeruginosa （91 stranim）. S. aureus（84 strains and A. baumannii（63 strains） The ratio of ESBLS of K. pneumoniae and E. coli was 45.2% and 41. 7%. respectively. The better antibiotics for them was Imipenern, Ciprofloxcain and Amikacin. Antibiotics resistance of gram-negative bacteria （K. Pneumoniae, E. coli,A, baumannii and P. aeruginosa） was high for ampicillin and cefazollin. MRSA ratio ofS. aureus was 14.3%. The best antibiotics were vancomyin,rifampicin and chloramphenicol. The isolation of E. cloacae was lower. But it has higher antibiotics resistance. Conclusion： The antibiotics resistance increases evidently. Bacterial culture of sputum should be examined when children are caught by LRTI.

关 键 词：下呼吸道感染 抗药性 儿童 

分 类 号：R978.1[医药卫生—药品]