儿童与成人下呼吸道感染革兰阴性菌分布及耐药性对比分析  

Comparative analysis of distribution and drug resistance of pathogenic Gram negative bacteria in lower respiratory tract infection of children and adult

作　　者：赵呈元[1] 倪军[2] 曹波[1] 徐飞[1] 谈华[1] 

机构地区：[1]南京医科大学附属南京儿童医院检验科,南京210008 [2]南京医科大学附属鼓楼医院检验科,南京210008

出　　处：《热带医学杂志》2015年第12期1614-1617,共4页Journal of Tropical Medicine

摘　　要：目的了解儿童下呼吸道感染革兰阴性菌的流行趋势和药物敏感性,为临床合理用药提供依据。方法分别对2014年南京医科大学附属南京儿童医院收治患儿的痰培养标本和南京医科大学附属鼓楼医院收治的成人患者痰培养标本进行病原菌培养以及药敏试验,并进行对比性分析。结果患儿的下呼吸道痰标本中分离出病原菌6 124株,其中革兰阴性菌3 840株,占62.7%,其分布较多的是流感嗜血杆菌(n=981)、肺炎克雷伯菌(n=729)、大肠埃希菌(n=680)、鲍曼不动杆菌(n=448)、铜绿假单胞菌(n=278)。成人患者的下呼吸道痰标本中分离出病原菌6786株,其中革兰阴性菌4 906株,占72.3%,其分布较多的是肺炎克雷伯菌(n=1 178)、大肠埃希菌(n=1 080)、铜绿假单胞菌(n=981)、鲍曼不动杆菌(n=883)。对革兰阴性菌敏感的药物有哌拉西林/他唑巴坦和亚胺培南。结论儿童下呼吸道感染病原菌以革兰阴性菌为主,且流感嗜血杆菌成为首要病原菌,加强细菌培养和耐药性监测对临床合理使用抗生素十分必要。Objective To understand the epidemic trend and drug susceptibility of pathogenic bacteria in children with lower respiratory tract infection,and provide the basis for clinical rational drug use. Methods Sputum samples were collected from the Nanjing Children＇s Hospital of Nanjing Medical University and Nanjing brain hospital in 2014 for cultivation of pathogenic bacteria and drug sensitivity test. Results 6 124 strains of bacteria were isolated from the lower respiratory tract sputum specimens in our hospital in 2014,including 3 840 strains of Gram negative bacteria,accounting for 62.7%;its main distribution was Haemophilus influenzae（n=981）,Klebsiella pneumoniae（n=729）,Escherichia coli（n=680）,Acinetobacter bauman（n=448）and Pseudomonas aeruginosa（n=278）. 6 786 strains of bacteria were isolated from the lower respiratory tract sputum specimens in Nanjing Brain Hospital were in 2014,including 4 906 strains of Gram negative bacteria,accounting for 72.3%;its main distribution was Klebsiella pneumoniae（n=1 178）,Escherichia coli（n=1 080）,Pseudomonas aeruginosa（n=981）and Acinetobacter baumannii（n=883）. The Gram-negative bacilli were sensitive to piperacillin / tazobactam and imipenem. Conclusions The Gram negative bacteria were the main pathogens of lower respiratory infection in children,and Haemophilus influenzae was the predominant pathogenic bacteria.It is important to enhance monitor the distribution and drug resistance of pathogenic bacteria and provide bais for rational use of antibiotics.

关 键 词：儿童 下呼吸道 病原菌分布 耐药性 

分 类 号：R378.2[医药卫生—病原生物学]