2013-2015年梧州市儿童社区获得性肺炎病原菌和耐药特征调查  

Pathogenic Bacteria of Community Acquired Pneumonia and their Drug Resistanceamong the Children from 2013 to 2015 in Wuzhou

作　　者：叶满[1] 文晓君[1] 

机构地区：[1]广西医科大学第七附属医院检验科,广西梧州543001

出　　处：《现代预防医学》2017年第10期1810-1813,共4页Modern Preventive Medicine

基　　金：梧州市科学研究与技术开发计划项目(201502101)

摘　　要：目的通过分析不同季节社区获得性肺炎(CAP)患儿痰培养病原菌阳性检测资料600例,了解梧州市儿童CAP病原菌分布和耐药现状,为该市临床诊治儿童CAP合理用药提供依据。方法随机选取2013-2015年600例CAP痰病原菌培养阳性患儿,按照不同季节进行病原菌分布和耐药分析。结果 600例CAP痰培养阳性患儿共分离622株细菌,其中革兰阴性菌313株,占50.32%;革兰阳性菌309株,占49.68%;主要病原菌为肺炎链球菌、大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、流感嗜血杆菌和卡他布兰汉菌等;青霉素不敏感肺炎链球菌为70.95%,未发现金黄色葡萄球菌对万古霉素具有耐药性;大肠埃希菌、肺炎克雷伯菌对常用抗生素耐药率较高,未发现对亚胺培南、美罗培南耐药。肺炎链球菌、流感嗜血杆菌、肺炎克雷伯菌在不同季节分布差异有统计学意义(χ2值分别为18.912、14.374、11.042,P≤0.05)。结论肺炎链球菌、流感嗜血杆菌、肺炎克雷伯菌在不同季节分布有差异,检出病原菌对常用抗生素有不同程度耐药,应根据药敏结果合理使用抗生素。Objective To learn the distribution of the pathogenic bacteria of Community Acquired Pneumonia （CAP）and their drug resistanceamong the children in Wuzhou by analyzing 600 pathogen-positive samples of sputum culture from children in different seasons, so as to provide basis for treating CAP in children properly. Methods Analyze the distribution and drug resistance of pathogens from 600 sputum culture samples from CAP children from different seasons during 2013 - 2015. Results 622 bacteria are isolated from 600 sputum samples. Among them, 313 were Gram-negative, accounting for 50.32% of the total. The rest of 309 wereGram positive bacteria （49.68%）. The main pathogens were Streptococcus pneumonia, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Haemophilus influenza and Branhamella catarrhalis and so on. 70.95% of S. pneumoniaisolates were resistant to penicillin. All S. aureus isolates were sensitive to vancomycin. The resistance of E. coli and K. pneumoniaeto regular antibiotics was relatively high, but they were all susceptible to imipenem and meropenem. Distribution of S. pneumoniae, H. influenzae, and K. pneumoniae varied with seasons significantly. Conclusion S. pneumoniae, H influenzae, K. pneumoniae have seasonal distribution （with Х^2 of 18.912, 14.374and11.042, respectively （P≤0.05））. Pathogens presented high resistance to commonly used antibiotics. So antibiotics should be used properly according to susceptibility test.

关 键 词：社区获得性肺炎 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]