儿童急性下呼吸道感染的病原菌及耐药性调查  

INVESTIGATION OF PATHOGENIC BACTERIA AND DRUG RESISTANCE IN CHILDREN WITH ACUTE LOWER RESPIRATORY TRACT INFECTION

作　　者：陈素玲[1] 赵若雯[1] 江霞辉[1] 

机构地区：[1]广东省茂名市妇幼保健院,525000

出　　处：《中国煤炭工业医学杂志》2010年第5期776-777,共2页Chinese Journal of Coal Industry Medicine

摘　　要：目的了解儿童急性下呼吸道感染的主要病原菌及其耐药性。方法将本院2008年1月—2009年12月住院及门诊1169例儿童急性下呼吸道感染的痰液标本经分离培养,做菌株鉴定和药物敏感试验。结果共分离培养出病原菌531株,总阳性率45.42%,其中革兰阴性菌317株,占59.7%;革兰阳性菌214株,占40.3%。革兰阴性菌以肺炎克雷伯杆菌、大肠埃希菌、铜绿假单胞菌和流感嗜血杆菌为主。肺炎克雷伯杆菌和大肠埃希菌较敏感的抗生素为亚胺培南、环丙沙星、阿米卡星、阿莫西林/克拉维酸钾、哌拉西林/他唑巴坦、头孢哌林/舒巴坦。对氨苄西林、哌拉西林钠、头孢唑啉、头孢呋辛、头孢噻肟钠耐药率较高。革兰阳性菌以肺炎链球菌、金黄色葡萄球菌和肠球菌为主。肺炎链球菌对苯唑类霉素、PG和红霉素的耐药率达63.95%～90.72%,金黄色葡萄球菌对红霉素、青霉素、克林霉素的耐药率平均超过63.74%,对万古霉素的耐药率为0。结论儿童急性下呼吸道感染的病原菌以革兰阴性菌为主,肺炎克雷伯杆菌、大肠埃希菌、肠球菌为主要病原菌对抗生素的耐药率较高,应积极加强监控,采取必要措施,防止耐药菌的流行。Objective To understand the main pathogens and their drug resistance of children with acute lower respiratory infection.Methods The in-patients hospitalized and outpatients in our hospital from Jan 2008 to Dec 2009,1169 cases of children with acute lower respiratory tract infections,were selected as subjects.Sputum samples were isolated and cultured,which were used to make strain identification and drug sensitivity test.Results A total of 531 pathogens were isolated and cultured,with a total positive rate of 45.42%.There was 317 gram-negative bacteria,accounting for 59.7%;gram-positive bacteria 214,accounting for 40.3%.Gram-negative bacteria were Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa and Haemophilus influenzae based.Klebsiella pneumoniae and Escherichia coli was more sensitive to antibiotics such as imipenem,ciprofloxacin,amikacin,amoxicillin /clavulanate potassium,piperacillin /tazobactam,cephalosporins Piperazine lin /sulbactam.To ampicillin,piperacillin,cefazolin,cefuroxime,cefotaxime morpholine,the resistance of which was higher.Gram-positive bacteria were included Streptococcus pneumoniae,Staphylococcus aureus and Enterococcus dominated.The resistance rates of Streptococcus pneumoniae oxacillin Class ADM,PG,and erythromycin were 63.95-90.72%,which of Staphylococcus aureus to erythromycin,penicillin,clindamycin were more than 63.74%,while which of the Vancomycin was 0.Conclusion Children,with acute lower respiratory tract infections and Gram-negative bacteria,pathogens,Klebsiella pneumoniae,Escherichia coli,Enterococcus as the main pathogens of the high rate of antibiotic resistance,should step up their monitoring and take necessary measures to prevent resistant epidemiology.

关 键 词：急性下呼吸道感染 细菌培养 耐药性 儿童 

分 类 号：R725.6[医药卫生—儿科]