小儿重症社区获得性肺炎274例细菌谱分析  

Analysis of Bacterium Spectrum of 274 Children with Severe Community-acquired Pneumonia

作　　者：李贵南[1] 杨龙贵[2] 罗海燕[2] 李先斌[3] 祝益民[2] 董静[2] 

机构地区：[1]湖南省儿童医院新生儿科,410007 [2]湖南省儿童医院儿科监护病房,410007 [3]湖南省儿童医院检验科,410007

出　　处：《岭南急诊医学杂志》2008年第5期330-332,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:社区获得性肺炎(CAP)是导致小儿死亡的主要疾病之一,本文旨在了解我院PICU重症CAP患儿的细菌病原学特点。方法:对2006年1月1日至12月31日我院PICU的274例CAP患儿痰液进行细菌检测。结果:阳性标本167例(60.95%),排前五位的细菌依次为化脓性链球菌41例(24.55%)、肺炎克雷伯杆菌39例(23.35%)、大肠埃希氏杆菌24例(14.37%)、肺炎链球菌11例(6.59%)和金黄色葡萄球菌11例(6.59%);痰液细菌检出率在年龄<3月患儿组明显高于≥3月患儿组(P=0.004);春夏季痰液细菌检出率高于秋冬季(P=0.035);病程在<5天组患儿痰液细菌检出率明显低于≥5天组(P=0.004)。结论:重症CAP的革兰氏阴性菌呈上升趋势,年龄<3个月的患儿为细菌感染性肺炎的高危人群,病程超过5天细菌感染的机率明显增加。Objective： Community-acquired pneumonia （CAP） that results death in children is one of principal disease. Aim is to understand the characteristics of bacterium etiology of severe CAP in PICU of our hospit.al. Method： The sputa from 274 CAP patients in PICU of our hospital were detected from January 1, 2006 to December 31,2006. Results：Positive rate is 60.95% （167 cases）. The front five kinds of bacterium are pyogenic streptococcus, Klebsiella pneumoniae, Escherichia coli, Streptococcus pneumoniae and Staphylococcus aureus, their front five ratios are 24.55% （41 cases）, 23.35% （39 cases）, 14.37% （24 cases）, 6.59% （11 cases） and 6.59% （11 cases）, respectively. The detection rate of sputum in patient groups of less than 3 months of age compared with the groups of exceed or equal to 3 months of age significantly increased （P=0.004）. The detection rate of sputum in spring and summer compared with autumn and winter significantly increased （P=0.035）. The detection rate of sputum in patient groups of less than 5 days of course of disease compared the groups of exceed or equal to 5 days of age significantly decreased （P=0.004）. Conclusion： The Gram-negative bacteria of severe CAP showed a rising tendency. Patients with pneumonia for bacterial infection less than 3 months of age are high risk group. The probability of bacterial infection significantly increased beyond 5 days of disease periods.

关 键 词：小儿 重症 社区获得性肺炎 细菌谱分析 

分 类 号：R725.6[医药卫生—儿科]