儿童重症监护室重症细菌性肺炎病原菌及耐药性分析  

Analysis of Composition and Resistance of Pathogens in Children with Severe Bacterial Pneumonia

作　　者：洪先欧[1] 刘纯义[1] 陆必森[1] 张侃[1] 吴丽娟[2] 缪小佟[2] 

机构地区：[1]广东省深圳市宝安区妇幼保健院儿科,518133 [2]广东省深圳市宝安区妇幼保健院检验科,518133

出　　处：《岭南急诊医学杂志》2010年第6期447-448,457,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨儿童重症监护室(PICU)重症细菌性肺炎病原菌分布及耐药情况,指导临床抗生素应用。方法:回顾性分析2008年1月至2009年9月我院PICU收治的重症细菌性肺炎192例的临床资料。结果:192例痰培养检出非重复细菌215株,前5位细菌分别为肺炎克雷伯杆菌、大肠埃希菌、肺炎链球菌、金黄色葡萄球菌及铜绿假单胞菌。G^-杆菌136株,其中肺炎克雷伯杆菌64株,大肠埃希菌38株,二者产ESBLs比例分别为70.3%和65.8%,对大多数青霉素类、头孢菌素类抗菌素耐药,对亚胺培南、环丙沙星、阿米卡星敏感性较高。结论:PICU重症细菌性肺炎病原菌以产ESBLs的肺炎克雷伯杆菌、大肠埃希菌为主,耐药率高,初始经验性治疗建议首选亚胺培南。Objective：To investigate the composition and drug resistance of pathogens in children with severe bacterial pneumonia in PICU and to provide information for clinically choosing antibiotics. Methods：Clinical data of 192 children contracting severe bacterial pneumonia in the PICU were analyzed retrospectively from Jan.2008 to Sep. 2009. Results： 215 strains of non-repetitive bacteria were detected from sputum in the 192 cases. The top five kinds of bacteria were Klebsiella pneumoniae,Eseherichia coli, Streptococcus pneumoniae, Staphylococcus aureus and Pseudomonas aeruginosa respectively. In 136 strains Gram-Negative bacillus, Klebsiella pneumoniae were 64 strains and Escherichia coil were 38 strains, and they produced ESBLs 70.3% and 65.8% respectively, possessing either high drug resistance towards most of the Penieillins and Cephalosporins antibiotics and high sensitivity to Imipenem, Ciprofloxaein and Amikacin. Conclusion： In PICU, the severe bacterial pneumonia are primarily affected by Gram- Negative bacillus with high resistance rate, especially by Klebsiella pneumonia and Escheriehia coli with ESBLs. We suggest that Imipenem should be selected as the first antibiotics in initial empirical treatment.

关 键 词：儿童重症监护室 肺炎 病原菌 耐药性 

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