儿童下呼吸道感染革兰阳性菌种类及耐药性分析  

Gram-positive pathogen identification and drug-resistance analysis in hospitalized children with lower respiratory tract

作　　者：王鑫磊[1] 张钊冠[2] 于新[3] 黄红兰[3] Wang Xinlei;Zhang Zhaoguan;Yu Xin;Huang Honglan(College of Basic Medical Science, Jilin University, Changchun 130000, China)

机构地区：[1]吉林大学第二医院检验科,长春130021 [2]吉林大学第一医院检验科 [3]吉林大学基础医学院病原生物学系,130000

出　　处：《中国医师进修杂志》2018年第5期449-451,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的了解住院儿童下呼吸道感染革兰阳性菌种类及耐药情况，指导临床合理应用抗生素。方法对1219份下呼吸道感染住院患儿的合格痰液标本分离培养情况和药敏试验结果进行总结。结果1219份合格痰液标本共分离出阳性菌株1249株，其中革兰阳性菌318株，占25．46％（318／1249）。318株革兰阳性菌中，金黄色葡萄球菌127株（39．94％），肺炎链球菌92株（28．93％），表皮葡萄球菌76株（23．90％），肠球菌23株（7．23％）。不同的革兰阳性菌对常用的抗菌药物表现出不同程度的耐药，尤其对青霉素耐药率最高（89．62％，285／318），而对红霉素、头孢唑林、苯唑西林、阿奇霉素及克林霉素也较高[66．67％（212／318）、52．52％（167／318）、49．06％（156／318）、49．06％（156／318）和43．08％（137／318）]，对万古霉素和利奈唑胺无耐药性。结论下呼吸道感染患儿应该根据病原菌的种类及药敏试验结果合理使用抗生素，才能有效地控制感染。Objective To monitor the clinical distribution of Gram-positive pathogen infection and drug-resistance situation in hospitalized children with lower respiratory tract, and guide rational application of antibiotics. Methods The isolated cultures results and drug sensitivity test result of 1 219 sputum specimens in hospitalized children with lower respiratory tract were studied. Results The 1 249 strains were isolated from 1 219 sputum specimen samples. Among which, Gram-positive pathogen was 318 strains, accounting for 25.46% （318/1 249）. In 315 strains Gram-positive pathogens, staphylococcus aureus was 127 strains （39.94%）, streptococcus pneumoniae was 92 strains （28.93%）, staphylococcus epidermidis was 76 strains （23.90%）, and enterococcus was 23 strains （7.23%）. Then, different strains of pathogens showed totally disparate drug-resistance situations, especially towards penicillin, and the drug resistant rate was highest （89.62%, 285/318）, while the drug resistant rates were also high among erythromycin, cefazolin, oxacillin, azithromycin and clindamycin： 66.67% （212/318）, 52.52% （167/318）, 49.06% （156/318）, 49.06% （156/318） and 43.08% （137/318）; meanwhile, the isolated Gram-positive pathogens showed no drug-resistance to vancomycin and linezolid. Conclusions Only using antibiotics rationally according to pathogen identification and drug sensitivity test result, can effectively control the pathogen infections.

关 键 词：儿童 呼吸道感染 革兰氏阳性菌 回顾性研究 

分 类 号：R446.5[医药卫生—诊断学] R725.6[医药卫生—临床医学]