儿童难治性支原体肺炎感染病原菌特点和耐药性分析及血清白细胞介素18、33变化研究  

Characteristic and drug resistance of pathogens in children with intractable mycoplasma pneumonia and changes of serum IL-18 and IL-33 levels

作　　者：吴琼 李艳华 廖震 顾承萍 高玉凤 Wu Qiong;Li Yanhua;Liao Zhen;Gu Chengping;Gao Yufeng(Department of Pediatrics,the Maternal and Child Health Hospital of Zhoushan,Zhoushan,Zhejiang 316000,China;Department of Emergency,Hangzhou Children's Hospital,Hangzhou,Zhejiang 310014,China;Department of Pediatrics,the Traditional Chinese Medicine Hospital of Puiuo District,Zhoushan,Zhejiang 316199,China)

机构地区：[1]舟山市妇幼保健院儿科,浙江省316000 [2]杭州市儿童医院急诊科,310014 [3]舟山市普陀区中医院儿科,浙江省316199

出　　处：《中国基层医药》2019年第21期2607-2611,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨儿童难治性支原体肺炎感染病原菌特点、耐药性及血清白细胞介素-18(IL-18)和白细胞介素-33(IL-33)细胞因子变化.方法选择舟山市妇幼保健院2016年1月至2017年12月收治的难治性支原体肺炎患儿103例作为研究组;另选择舟山市妇幼保健院同期健康体检者60例作为对照组.所有难治性支原体肺炎患儿采集口咽部分泌物,分离培养病原菌;采用纸片扩散法(K-B法)检测主要病原菌耐药情况;采用酶联免疫吸附法测定血清IL-18和IL-33含量.结果难治性支原体肺炎患儿103例分离培养病原菌117株,其中以革兰阴性杆菌为主,分离出68株,占58.12%;其次为革兰阳性球菌39株,占33.33%;真菌最少,10株,占8.55%.主要革兰阴性杆菌中,肺炎克雷伯菌对头孢呋辛耐药率较高,鲍曼不动杆菌对头孢呋辛和头孢曲松耐药率较高.主要革兰阳性球菌中,金黄色葡萄球菌和表皮葡萄球菌对红霉素和青霉素G耐药率较高.研究组血清IL-18和IL-33水平均高于对照组,差异均有统计学意义(均P<0.05).结论儿童难治性支原体肺炎感染病原菌以革兰阴性杆菌为主,主要革兰阴性杆菌对头孢类药物耐药率较高,主要革兰阳性球菌对青霉素G和红霉素耐药率较高,且患者血清IL-18和IL-33表达明显升高.Objective To investigate the characteristics and drug resistance of pathogenic bacteria of refractory mycoplasma pneumonia in children and the changes of serum interleukin-18(IL-18)and interleukin-33(IL-33)levels.Methods From January 2016 to December 2017,103 children with refractory mycoplasma infection admitted to the Maternal and Child Health Hospital of Zhoushan were selected in the study.Another 60 healthy subjects in our Hospital from January 2016 to December 2017 were selected as control group.The oropharyngeal secretions were collected in all children with refractory mycoplasma pneumonia,isolated and cultured pathogenic bacteria.Disk diffu-sion(K-B method)was used to detect the drug resistance of the main pathogens.Enzyme-linked immunosorbent assay was used to determine serum IL-18 and IL-33 levels.Results The 117 strains of pathogenic bacteria were isolated from 103 children with refractory mycoplasma infection,of which 68 strains(58.12%)were Gram-negative bacilli,39 strains(33.33%)were Gram-positive cocci,and 10 strains(8.55%)were fungi.Klebsiella pneumoniae was more resistant to cefuroxime than Acinetobacter baumannii to cefuroxime and ceftriaxone.Staphylococcus aureus and Staphylococcus epidermidis were more resistant to erythromycin and penicillin G than other Gram-positive cocci.The levels of serum IL-18 and IL-33 in the study group were higher than those in the control group(all P<0.05).Conclusion Gram-negative bacilli are the main pathogens of refractory mycoplasma pneumonia in children.The resistant rate of main Gram-negative bacilli to cephalosporins is higher.The resistant rate of main Gram-positive cocci to penicillin G and erythromycin is higher.The levels of serum IL-18 and IL-33 are significantly higher in patients with refractory mycoplasma pneumonia.

关 键 词：肺炎 支原体 病原 耐药性 白细胞介素-18 白细胞介素-33 

分 类 号：R44[医药卫生—诊断学]