婴幼儿大肠埃希菌性肺炎177例临床分析  

Clinical analysis of pneumonia infected with escherichia coli in 177 infants

作　　者：谢庆玲[1] 唐晓燕[1] 甄宏[1] 庞智东[2] 梁卓信 李伟伟[4] 包增兰[2] 陈泓伶[5] 贺海兰[1] 

机构地区：[1]广西壮族自治区人民医院儿科,南宁530021 [2]南宁市妇幼保健院,广西530021 [3]柳州市妇幼保健院,广西540001 [4]广西中医药大学第一附属医院,南宁530022 [5]广西医科大学第一临床医学院,南宁530021

出　　处：《中国临床新医学》2014年第2期108-111,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西科学研究与技术开发计划项目(编号:桂科攻0993003B-5;桂科攻0993003B-30)

摘　　要：目的分析婴幼儿大肠埃希菌性肺炎患儿的临床特征及药敏情况,指导临床肺炎诊治。方法回顾性分析177例住院婴幼儿大肠埃希菌性肺炎患儿的临床表现、X线表现、细菌耐药情况及治疗预后。结果患儿的临床表现主要的症状为咳嗽、咳痰、发热,容易出现呼吸困难。X线主要表现为片状影或间质渗出。大肠埃希菌多数菌株对泰能、美平、头孢他定、丁胺卡那霉素、左氧氟沙星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦敏感性高,对大多数β内酰胺类抗生素普遍耐药。产超广谱β内酰胺酶(ESBLs)菌33例,阳性率为18.6%。痰液培养细菌阳性转阴比较慢,治疗主要以经验疗法和药敏试验结果结合,病程迁延,预后尚好。结论婴幼儿大肠埃希菌肺炎是儿科常见病,临床诊治相对容易。但大肠埃希菌抗菌药物的耐药率高,需引起重视。Objective To analyze the clinical characteristics and antimicrobial susceptibility of pneumonia infected with Escherichia coli in infants for clinical pneumonia treatment .Methods Retrospective analysis was per-formed for 177 cases of pneumonia infected with Escherichia coli in hospitalized infants with clinical manifestations , X-ray findings , bacterial drug resistance and treatment outcome .Results The main symptoms of clinical manifesta-tions in infants of pneumonia infected with Escherichia coli were cough , sputum, fever, and likely to prone to breath-ing difficulties .X-ray mainly showed patchy or interstitial exudation .The drug sensitivity test showed that Escherichia coli were sensitive to tienam, mei-ping, ceftazidime, amikacin,levofloxacin, piperacillin/tazobacta and cefopera-zone/sulbactam.While they were resistant to most β-lactam antibiotics.There were 33 cases of pneumonia of Esche-richia coli with producing extended-spectrum β-lactamase（ESBLs） bacteria with 18.6% positive rate.The negative conversion sputum culture of Escherichia coli in pneumonia infants was relatively slow .Treatment for pneumonia in-fected with Escherichia coli in infants was mainly empirical therapy combined with drug susceptibility test results ac -cording to sputum culture of Escherichia coli , while the prognosis of pneumonia infected with Escherichia coli was still good although prolonged course .Conclusion Escherichia coli pneumonia in infants was a common pediatric disea-ses, which clinical diagnosis relatively easy .However, there be likely needed to pay attention to higher antimicrobial resistance to Escherichia coli .

关 键 词：肺炎 大肠埃希菌 临床特征 微生物敏感性试验 婴幼儿 

分 类 号：R72[医药卫生—儿科]