兰州地区儿童社区获得性肺炎病原菌分布及耐药性分析  

Analysis on bacterial distribution and drug resistance in community acquired pneumonia children in Lanzhou area

作　　者：马建丽[1] 王小明[1] 

机构地区：[1]兰州市第二人民医院小儿科,甘肃兰州730046

出　　处：《中国妇幼保健》2017年第2期298-300,共3页Maternal and Child Health Care of China

摘　　要：目的探讨并分析儿童社区获得性肺炎病原菌分布情况及其耐药性,为儿童社区获得性肺炎的合理治疗提供临床依据。方法选取2013年8月-2015年3月该院儿科收治的325例社区获得性肺炎患儿作为研究对象,检测各患儿痰液、血液及咽拭子中的病原菌。结果 325份送检标本中,186份检出病原(总检出率56.88%),共检出244株病原,其中细菌菌株59株(24.19%)、病毒71株(29.10%)、非典型病原114株,其中含肺炎支原体85株(34.84%)、肺炎衣原体24株(9.84%)。55例患儿(29.57%)存在混合感染,其中以支原体和细菌或病毒的混合感染为主。细菌感染的前3位分别为:肺炎克雷伯氏菌(17例)、大肠埃希氏菌(16例)及金黄色葡萄球菌(12例),这些细菌对氨苄西林耐药率高,对头孢三代部分耐药,对哌拉西林/他唑巴坦及亚胺培南敏感性高。结论儿童社区获得性肺炎以肺炎支原体感染最为常见,其次分别为肺炎克雷伯氏菌、大肠埃希氏菌及金黄色葡萄球菌。在临床中,应充分考虑上述发病特征,选择合适的药物进行针对性的治疗,提高治疗效果,有效改善患者预后。Objective To explore and analyze bacterial distribution and drug resistance in community acquired pneumonia children in Lanzhou area,provide a clinical basis for rational therapy of community acquired pneumonia children. Methods A total of 325 children with community acquired pneumonia were selected from the hospital from August 2013 to March 2015 as research objects,then the pathogens in sputum,blood,and pharyngeal swabs of children were detected respectively. Results A total of 186 pathogenic bacteria were detected among 325 samples,the total detection rate was 56. 88%,244 strains were detected,including 59 bacterial strains（ 24. 19%）,71 viral strains（ 29. 10%）,114 atypical pathogen strains,in which 85 Mycoplasma pneumoniae strains（ 34. 84%） and 24 Chlamydia pneumoniae strains（ 9. 84%） were included. Mixed infection occurred in 55 children（ 29. 57%）,the main type was mycoplasma combined with bacteria or virus. The top three infectious bacteria were Klebsiella pneumoniae（ 17 cases）,Escherichia coli（ 16 cases） and Staphylococcus aureus（ 12 cases）,these bacteria had high resistance rate to ampicillin,and they were resistant to the third generation cephalosporin partially,which had high sensitivity to piperacillin / tazobactam and imipenem. Conclusion The most common pathogen in children with community acquired pneumonia is Mycoplasma pneumonia,followed by Klebsiella pneumoniae,Escherichia coli and Staphylococcus aureus. In clinical work,we should fully consider the above-mentioned characteristics and select the appropriate drug for targeted therapy to improve the treatment effect and prognosis of patients.

关 键 词：儿童 社区获得性肺炎 病原菌 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]