5岁以下儿童下呼吸道肺炎链球菌感染特点及耐药性分析  

Characteristics and drug resistance of Streptococcus pneumoniae in children under 5 years

作　　者：范向平[1] Fan Xiangping(Department of Clinical Laboratory,Huizhou Central People’s Hospital,Huizhou 516001,China)

机构地区：[1]广东省惠州市中心人民医院检验科,516001

出　　处：《中国实用医刊》2018年第24期17-19,共3页Chinese Journal of Practical Medicine

摘　　要：目的分析5岁以下的下呼吸道感染患儿肺炎链球菌感染的特点及其耐药性。方法选取2016年3月至2017年12月惠州市中心人民医院收治的1 571例5岁以下的下呼吸道感染患儿为研究对象,对所有患儿进行肺炎链球菌鉴定,确定阳性率,对细菌鉴定阳性患儿的感染特点进行分析,对患儿进行耐药性试验,分析耐药性特点。结果 1 571例患儿中,有118例肺炎链球菌培养阳性,感染率为7.51%;感染类型以肺炎为主;1岁以下患儿占比高于1~3岁(含)及3~5岁患儿,冬季发病患儿占比高于其他3个季节,不同性别患儿占比较接近;患儿对红霉素、克林霉素以及复方新诺明均有较高的耐药性,分别为87.29%、90.68%和76.27%,而对氯霉素、万古霉素以及左氧氟沙星的耐药性很低,分别为4.24%、0.00%和0.85%。结论 5岁以下下呼吸道感染患儿中,1岁以下患儿更易感染肺炎链球菌;肺炎为主要疾病类型;肺炎链球菌感染有季节差异性,应将冬季作为重点防护时期;肺炎链球菌感染患儿普遍对抗生素有耐药性,应该强化临床用药管理工作。Objective To analyze the characteristics and drug resistance of Streptococcus pneumoniae infection in children under 5 years old with lower respiratory tract infection. Methods From March 2016 to December 2017, 1 571 cases of lower respiratory tract infection under 5 years of age in Huizhou Central People’s Hospital were studied. All of the children were identified with Streptococcus pneumoniae, the positive rate was determined, the infection characteristics of the children with positive bacteria identification were analyzed, the drug resistance test was carried out to the children and the drug resistance characteristics were analyzed. Results Among the 1 571 cases, 118 cases of Streptococcus pneumoniae were positive, the infection rate was 7.51%, the type of infection was mainly pneumonia, the proportion of children under 1 years old was higher than that of 1~3 years (including) and 3~5 years old, and the proportion of children in winter was higher than the other three seasons, and the children of different sex were close. The drug resistant rates to erythromycin, clindamycin and trimethoprim were high, which were 87.29%, 90.68% and 76.27% respectively, while the drug resistance rates to chloramphenicol, vancomycin and levofloxacin were very low, which were 4.24%, 0% and 0.85%, respectively. Conclusions Among the children under 5 years old with lower respiratory tract infection, children under 1 year old are more likely to be infected with Streptococcus pneumoniae;pneumonia is the main type of disease;Streptococcus pneumoniae infection has seasonal differences, and winter protection period should be the focus of protection;Streptococcus pneumoniae infection in children are generally resistant to antibiotics, and the management of clinical medicationshould be strengthened.

关 键 词：儿童 下呼吸道感染 肺炎链球菌感染特点 耐药性 

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