267例支气管镜检查患儿肺泡灌洗液的病原学分析  

Etiological Analysis of Alveolar Lavage Fluid in 267 Children with Bronchoscopy

作　　者：朱勇斌[1] 方金涌[1] 郑铭城 王梵烨 ZHU Yongbin;FANG Jinyong;ZHENG Mingcheng;WANG Fanye(Jieyang People’s Hospital,Jieyang 522000,China;不详)

机构地区：[1]广东省揭阳市人民医院,广东揭阳522000

出　　处：《中国医学创新》2020年第14期76-79,共4页Medical Innovation of China

摘　　要：目的:探讨267例行支气管镜检查患儿的肺泡灌洗液的病原学分布特征。方法:选取2016年7月-2019年12月于本院行支气管镜检查的患儿267例。所有患儿均行支气管镜检查并留取肺泡灌洗液,分别做抗酸染色、结核杆菌聚合酶链式反应(PCR)、细菌培养、肺炎支原体及肺炎衣原体RNA-PCR检查。观察各检查结果、分析致病菌分布及主要致病菌耐药性。结果:267例患儿中抗酸染色阳性2例(0.75%);结核杆菌PCR检测阳性4例(1.50%);肺炎支原体及肺炎衣原体RNA-PCR阳性79例(29.59%);细菌培养阳性84例(31.46%)。84例细菌培养阳性中主要致病菌为肺炎链球菌(38.10%)、流感嗜血杆菌(32.14%)、金黄色葡萄球菌(9.52%)、卡他莫拉菌(5.95%)、肺炎克雷伯菌(4.76%)及大肠埃希菌(3.57%)。流感嗜血杆菌对复方新诺明与左氧氟沙星耐药性均较高;肺炎克雷伯菌与卡他莫拉菌均对复方新诺明耐药性最高;大肠埃希菌对复方新诺明、头孢他啶及头孢曲松耐药性均较高。肺炎链球菌对红霉素与四环素耐药性较高;金黄色葡萄球菌对青霉素耐药性最高。金黄色葡萄球菌多重耐药比例最高。结论:267例支气管镜检查患儿的肺泡灌洗液病原菌分布广泛,主要致病菌为肺炎链球菌、流感嗜血杆菌及金黄色葡萄球菌,且对多种抗菌药物耐药性不同,其中金黄色葡萄球菌多重耐药较为常见。Objective:To investigate the etiological distribution of alveolar lavage fluid in 267 children with bronchoscopy.Method:A total of 267 children underwent bronchoscopy in our hospital from July 2016 to December 2019 were selected.All children were examined by bronchoscopy,and alveolar lavage fluid was collected for acid-fast staining,polymerase chain reaction (PCR) of tuberculosis bacteria,bacterial culture,RNA-PCR of Mycoplasma pneumoniae and Chlamydia pneumoniae.All test results were observed and the distribution and drug resistance of main pathogenic bacteria were analyzed.Result:Among the 267 cases,2 cases (0.75%) were positive for acid-fast staining.4 cases (1.50%) were positive for tuberculosis bacteria PCR test.79 cases (29.59%) were Mycoplasma pneumoniae and Chlamydia pneumoniae RNA-PCR positive.84 cases (31.46%) were positive in bacterial culture.The main pathogenic bacteria in the 84 cases with positive in bacterial culture were Streptococcus pneumoniae (38.10%),Haemophilus influenzae (32.14%),Staphylococcus aureus (9.52%),Moraxella cachaca (5.95%),Klebsiella pneumoniae (4.76%) and Escherichia coli (3.57%).The drug resistance of Haemophilus influenzae to Compound Sulfamethoxazole and Levofloxacin was high.Both Klebsiella pneumoniae and Moraxella catarrhalis had the highest Resistance to Compound Sulfamethoxazole.Escherichia coli had high resistance to Compound Sulfamethoxazole,Ceftazidine and Ceftriaxone.Streptococcus pneumoniae has high resistance to Erythromycin and Tetracycline.Staphylococcus aureus is the most resistant to Penicillin.Staphylococcus aureus had the highest rate of multiple drug resistance.Conclusion:The pathogenic bacteria of alveolar lavage solution in 267 children with bronchoscopy were widely distributed,and the main pathogenic bacteria were Streptococcus pneumoniae,Haemophilus influenzae and Staphylococcus aureus,they have different resistance to multiple antibacterials,among which multiple drug resistance of Staphylococcus aureus was more common.

关 键 词：支气管镜检查 肺泡灌洗液 病原学 

分 类 号：R725.6[医药卫生—儿科]