小儿医院获得性肺炎的病原菌及危险因素分析  

Analysis of pathogenic bacteria and risk factors in children of hospital acquired pneumonia

作　　者：张艺[1] 帅向华[1] 余道军[2] 

机构地区：[1]浙江省杭州市第一人民医院儿科,310006 [2]浙江省杭州市第一人民医院检验科,310006

出　　处：《中华全科医学》2014年第3期344-346,共3页Chinese Journal of General Practice

基　　金：浙江省公益性技术应用研究计划项目(2012-C37094);杭州市卫生科技计划重大项目(2012ZD001)

摘　　要：目的调查儿童医院院内获得性肺炎(HAP)的病原菌构成,并分析HAP的危险因素。方法采集深部痰,进行革兰氏染色、细菌培养及药敏测定,并对HAP患儿危险因素进行非条件多因素Logistic回归分析。结果56例HAP患儿以革兰氏阴性菌(90.4%)感染居多,前4位分别是铜绿假单胞菌25%(14/56)、肺炎克雷伯菌21.4%(12/56)、大肠埃希氏菌14.3%(8/56)、鲍曼不动杆菌10.7%(6/56)。Logistic回归分析显示,HAP与住院时间大于7 d(P<0.01)、侵入性操作(P<0.01)、三代头孢菌素应用(P<0.05)相关。结论小儿HAP病原菌以革兰氏阴性菌多见,住院时间长、侵入性操作、三代头孢菌素应用是小儿HAP的独立危险因素。Objective To investigate the pathogenic bacteria and analyze the risk factors in children of hospital-acquired pneumonia（HAP）. Methods Deep sputum were collected, gram dyeing, bacterial culture and sensitivity test were performed. Risk factors were analyzed with multiple Logistic regression analysis for HAP children. Results Gram-negative bacilli （90.4%） was predominate pathogenic bacteria in HAP children. First four bacterial were pseudomonas aeruginosa in 25% , klebsiella pneumoniae in 21.4%, Eseheriehia coli. in 14.3%, and Baumanli in 10.7%. Multiple logistic regression analysis showed that HAP was related with hospital stays than 7 days（ P 〈 0. 01 ） , invasive operation（ P 〈 0. 01 ） , using third generation cephalosporine （ P 〈 0. 05 ）. Conclusion Gram-negative bacilli was the most common pathogenic bacteria in HAP children. Long period in hospital,invasive operation, using third generation cephalosporine were the independent risk factors for HAP children.

关 键 词：医院获得性肺炎 病原菌 耐药 儿童 危险因素 

分 类 号：R725.6[医药卫生—儿科] R563.1[医药卫生—临床医学]