儿童下呼吸道感染病原菌分布及耐药性分析  

Pathogen Distribution and Antibiotic Resistance in Children with Lower Respiratory Tract Infection

作　　者：李方去[1] 李向阳[1] 杨锦红[1] 方晔[1] 韩珍[1] 

机构地区：[1]温州医学院附属育英儿童医院检验科,浙江温州325027

出　　处：《中华医院感染学杂志》2009年第3期344-346,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解温州地区儿童下呼吸道感染的病原学特点及病原菌耐药情况。方法收集2004年1月-2006年12月从临床住院患儿下呼吸道分泌物分离的病原菌,药敏试验采用K-B法。结果从所送检的标本中检出病原菌1605株,其中革兰阳性菌399株(24.9%),革兰阴性菌982株(61.2%),真菌224株(14.0%);产超广谱β-内酰胺酶(ESBLs)大肠埃希菌、肺炎克雷伯菌的分离率分别为60.5%和54.6%,耐青霉素肺炎链球菌(PRSPN)的检出率为30.6%,耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为20.5%,亚胺培南对革兰阴性杆菌的体外抗菌活性最强,万古霉素对革兰阳性球菌的体外抗菌活性最强。结论3年住院患儿下呼吸道感染的病原菌仍以革兰阴性菌为主,但多药耐药的细菌及真菌的分离率呈上升趋势。OBJECTIVE To analyze the profile of the pathogens and their drug resistance isolated from children with lower respiratory tract infection in Wenzhou area from Jan 2004 to Dec 2006. METHODS Lower respiratory tract secretions were obtained from children with lower respiratory tract infection for bacterial culture. The K-B method was applied for the antibiotic susceptibility test. RESULTS Total 1605 strains were isolated. The isolating rates of Gram-positive cocci, Gram-negative bacilli and fungi were 24.9%, 61.2% and 14.0%, respectively. 60.5% and 54.6 % of the isolates of Escherichia coli and Klebsiella pneumoniae produced extended-spectrum beta-lactamases （ESBLs）. The rate of Penicillin-resistant Streptococcus pnenmoniae （PRSPN） was 30. 6%. 20. 5% isolates of Staphylococcus aureus were MRSA. All isolates of Enterobacteriaceae and Gram-positive cocci were susceptible to imipenem and vancomycin in vitro. CONCLUSIONS Gram-negative bacilli are still the primary pathogens resulting in lower respiratory tract infection in children. Fungi and muti-drug-resistant bacteria are on the rise trend.

关 键 词：下呼吸道感染 病原菌 耐药性 儿童 

分 类 号：R378[医药卫生—病原生物学]