我院儿童细菌性结膜炎病原菌临床分布特点及耐药情况分析  

Clinical distribution and drug resistance of pathogens in children with bacterial conjunctivitis in our hospital

作　　者：王铁桥[1] 肖大立[1] 廖炽泉 方瑞[1] 王穗琼[1] 邓文喻[1] WANG Tieqiao;XIAO Dali;LIAO Chiquan;FANG Rui;WANG Suiqiong;DENG Wenyu(Guangdong Maternal and Child Health Hospital,Guangzhou 510010,China)

机构地区：[1]广东省妇幼保健院,广东广州510010

出　　处：《广东药科大学学报》2021年第5期115-119,共5页Journal of Guangdong Pharmaceutical University

基　　金：广东省医学科研基金(A2020432)。

摘　　要：目的分析我院细菌性结膜炎患儿病原菌临床分布及耐药情况,为儿科抗感染治疗提供决策依据。方法采集379例急性结膜炎患儿结膜囊分泌物进行细菌培养,并对培养阳性的菌群分布及耐药性进行分析。结果379份标本共分离病原菌272株(检出率71.8%),其中革兰阳性菌140株(占检出菌的51.5%),革兰阴性菌132株(占检出菌的48.5%)。主要的阳性菌为金黄色葡萄球菌和肺炎链球菌(分别占阳性菌的73.6%和25.0%),主要的阴性菌是流感嗜血杆菌(占阴性菌的53.8%)。细菌性结膜炎患儿病原菌检出率在发生年龄段以及时间(季度)方面差异有统计学意义(P<0.05)。耐药监测结果:耐甲氧西林金黄色葡萄球菌(简称MRSA)检出率为17.50%。金黄色葡萄球菌对利奈唑胺及万古霉素完全敏感,对儿童常用抗菌药物如青霉素、红霉素和克林霉素等的耐药率较高(>60%);肺炎链球菌对万古霉素及利奈唑胺全部敏感,对阿莫西林、头孢噻肟等的耐药率低(<10%),对红霉素、克林霉素和复方新诺明等的耐药率高(>70%);流感嗜血杆菌对氨苄西林、复方新诺明以及头孢克洛等的耐药率较高(>60%),对头孢噻肟、利福平等的耐药率低(<10%)。结论小儿细菌性结膜炎在发生年龄段以及时间(季度)方面存在差异,主要致病菌是金黄色葡萄球菌、肺炎链球菌和流感嗜血杆菌,其对儿童部分常用抗菌药物耐药水平较高,临床治疗应依据耐药情况合理选择抗菌药物。Objective To analyze the clinical distribution and drug resistance of pathogenic bacteria in children with bacterial conjunctivitis in our hospital,so as to provide decision-making basis foranti-infection treatment in pediatrics.Methods 379 cases of conjunctival secretions from children with acute conjunctivitis were collected for bacterial culture,and the distribution and drug resistance of the positive bacteria were analyzed.Results 272 strains of pathogens were isolated from 379 samples(71.8%),including 140 strains of Gram-positive bacteria(51.5%)and 132 strains of Gram-negative bacteria(48.5%).The main positive bacteria were Staphylococcus(S.)aureus and Streptococcus(S.)pneumoniae(accounting for 73.6%and 25.0%of the positive bacteria respectively),and the negative bacteria were Haemophilus(H.)influenzae(accounting for 53.8%of the negative bacteria).There were significant differences in age and time(quarter)of bacterial conjunctivitis(P<0.05).In terms of drug resistance monitoring,the detection rate of methicillin resistant S.aureus(MRSA)was 17.50%.S.aureus was completely sensitive to linazolamide and vancomycin,and the drug resistance rate to antibiotics commonly used in children such as penicillin,erythromycin and clindamycin was high(>60%).S.pneumoniae was sensitive to vancomycin and linazolamide.The drug resistance rate to amoxicillin and cefotaxime was lower(<10%),and the drug resistance rate to erythromycin,clindamycin and compound xinnuomine was higher(>70%).The drug resistance rate of H.influenzae to ampicillin,compound xinnomine and cefaclor was higher(>60%),and the drug resistance rate to cefotaxime and rifampicin was lower(<10%).Conclusion There are differences in the age and time(quarter)of bacterial conjunctivitis in children.The main pathogens are S.aureus,S.pneumoniae and H.influenzae.Their resistance to some commonly used antibiotics in children is high.Antibiotics should be reasonably selected according to the drug resistance in clinical treatment.

关 键 词：儿童 结膜炎 病原菌 耐药性分析 

分 类 号：R378[医药卫生—病原生物学]