小儿呼吸系统感染病原菌的耐药性分析  

Drug resistance of pathogens in childhood respiratory tract infection

作　　者：高蕊[1] 王彦军[2] 杨亚荣[1] 

机构地区：[1]西安市儿童医院感染科,陕西西安710003 [2]第四军医大学西京医院急诊科,陕西西安710032

出　　处：《中国妇幼健康研究》2017年第11期1440-1442,共3页Chinese Journal of Woman and Child Health Research

摘　　要：目的分析引发小儿呼吸系统感染病原菌的耐药性,为抗菌类药物合理使用提供参考依据。方法对2016年1至12月西安市儿童医院感染科收治的256例患儿的798份痰液样本进行检测,并对检测结果进行分析。结果在798份送检样本中检测到病原菌265株,阳性率为33.21%;其中革兰阴性菌(G-)13种,184株,革兰阳性菌(G+)4种,32株,真菌3种,49株;病原菌种属检出率间差异具有统计学意义(χ~2=235.374,P<0.05)。铜绿假单胞菌对氨苄西林、复方磺胺甲噁唑具有较高耐药率;肺炎克雷伯菌、大肠埃希菌均对β-内酰胺类抗菌药物具有高度耐药性;流感嗜血杆菌对β-内酰胺类、复方磺胺甲噁唑和第二代头孢类抗生素耐药率均在60%~100%之间;嗜麦芽窄食单胞菌对β-内酰胺类、头孢吡肟氨基糖苷类和碳青霉烯类高度耐药;金黄色葡萄球菌对β-内酰胺类、红霉素、复方磺胺甲噁唑、左氧氟沙星、林可胺类敏感性低;白色念珠菌对抗菌药物敏感性均较高。结论小儿呼吸系统感染主要细菌性病原菌对常用β-内酰胺类抗生素均表现出较高耐药性,临床用药时应选择经验用药,同时及时检测,根据病原菌谱和药敏结果合理用药。Objective To explore the drug resistance of pathogens causing respiratory tract infection in children so as to provide reference for the rational use of antimicrobial agents.Methods A total of 798 sputum samples from 256 children admitted in department of infectious diseases in Xi＇an Children＇s Hospital were examined during January to December in 2016,and detection results were analyzed.Results Totally 265 strains of pathogens were isolated from 798 sputum samples with the detection rate of 33.21%,including 13 species（184 strains）of Gram-negative bacteria,4 species（32 strains）of Gram-positive bacteria,and 3 fungi（49 strains）.There was significant difference in pathogens detection rate（χ~2=235.374,P〈0.05）.The drug resistance of Pseudomonas aeruginosa to ampicillin and compound sulfamethoxazole was high,and that of Klebsiella pneumoniae and Escherichia coli to β-lactam antibiotics was high.The drug resistance of Haemophilus influenzae toβ-lactam,compound sulfamethoxazole and second-generation cephalosporins was between 60% and 100%.Stenotrophomonas maltophilia was highly resistant toβ-lactam,cefepime aminoglycosides and carbapenems.Staphylococcus aureus was not sensitive to β-lactam,erythromycin,compound sulfamethoxazole,levofloxacin and linofenam.Candida albicans was more sensitive to antimicrobial agents.Conclusion Bacterial pathogens in childhood respiratory tract infection show high resistance to commonly usedβ-lactam antibiotics.Clinical treatment should choose the experience medication,and the samples of patients are tested in a timely manner.Antibacterial agents are selected according to the pathogen spectrum and drug sensitive results.

关 键 词：呼吸系统感染 病原菌 耐药性 小儿 抗生素 

分 类 号：R725.6[医药卫生—儿科]