抚州市区小儿社区获得性下呼吸道感染主要病原菌分布、耐药性与年龄相关的研究  

Correlation between distribution,antibiotic resistance and age of main pathogens of community-acquired lower respiratory tract infection in children in Fuzhou

作　　者：付立新 周志明 郝会青 王平珍 周优树 FU lixin;ZHOU zhiming;HAO huiqing;WANG pingzhen;ZHOU youshu(Outpatient Department of Employee Medical Insurance in Fuzhou;Fuzhou Central Blood Station;Fuzhou Maternal and Child Health Hospital(The second People’s Hospital)Jiangxi,Fuzhou 344000)

机构地区：[1]抚州市职工医疗保险门诊部 [2]抚州市中心血站 [3]抚州市妇幼保健(第二人民医)院,江西抚州344000

出　　处：《实验与检验医学》2021年第5期1087-1093,共7页Experimental and Laboratory Medicine

基　　金：抚州市科技局2020年科技计划项目(抚科计字〔2020〕10号文)。

摘　　要：目的探讨小儿社区获得性下呼吸道感染主要病原菌分布及耐药性与年龄的相关性,为7岁以下小儿获得性下呼吸道感染的预防及治疗提供依据。方法选取因患有社区获得性下呼吸道感染而就诊于抚州市妇幼保健院的小儿作为研究对象,采集其痰液标本进行病原菌培养与药敏试验分析,观察不同年龄段小儿社区获得性下呼吸道感染主要病原菌分布及耐药性的分布情况。结果共分离出病原菌314株,排名前5位的主要病原菌分别为肺炎链球菌(占30.6%)、肺炎克雷伯菌(占21.3%)、大肠埃希菌(占15.6%)、流感嗜血杆菌(占15.3%)、铜绿假单胞菌(占5.7%);其新生儿期主要以大肠埃希菌和肺炎克雷伯菌为主,婴儿期主要以肺炎链球菌和肺炎克雷伯菌为主,幼儿期和学龄前期均主要以肺炎链球菌为主,5种主要病原菌均主要分布于婴儿期,且5种主要病原菌的分离率在≤28d、29d~1岁、1~3岁、3~7岁患儿间比较差异具有统计学意义(χ^(2)=57.92,P=0.000<0.05);肺炎链球菌对红霉素、克林霉素、头孢呋辛和四环素耐药率均>75%,对复方新诺明耐药率>38%,对青霉素、阿莫西林/克拉维酸、头孢曲松、美罗培南、左氧氟沙星、万古霉素、利奈唑胺有较强敏感性(耐药率<7.7%);肺炎克雷伯菌除幼儿期和学龄前期的各1例外,其他对头孢呋辛、头孢西丁、复方新诺明、氯霉素有一定的耐药性(10%≤耐药率≤30%),对头孢他啶、头孢吡肟、β-内酰胺合剂、碳青霉烯类、氨基糖苷类、喹诺酮类敏感性极强(耐药率≤10%);大肠埃希菌除幼儿期和学龄前期各1例外,其他对氨苄西林有极强耐药性(耐药率>78%),对头孢菌素类、喹诺酮类、复方新诺明、庆大霉素、氯霉素有较强的耐药性(7%<耐药率<71%),对β-内酰胺合剂、亚胺培南、美罗培南、阿米卡星敏感性极强(耐药率<7.1%);流感嗜血杆菌对哌拉西林/他唑巴坦、阿莫西林/克拉维酸�Objective To explore the correlation between distribution,antibiotic resistance and age of main pathogens of community-acquired lower respiratory tract infection in children in Fuzhou,providing the theoretical basis for the prevention and treatment in children under 7 years old.Methods Children with community-acquired lower respiratory tract infection in Fuzhou Maternal and Child Health Hospital were selected as the research objects,and their sputum samples were collected for pathogen culture and antibiotic sensitivity test.The distribution and antibiotic resistance of the pathogenic bacteria in different age groups were collected and analyzed.Results A total of 314 strains of pathogenic bacteria were isolated,and the top five were Streptococcus pneumoniae(30.6%),Klebsiella pneumoniae(21.3%),Escherichia coli(15.6%),Haemophilus influenzae(15.3%),and Pseudomonas aeruginosa(5.7%).Escherichia coli and Klebsiella pneumoniae were the main pathogenic bacteria in neonatal period,Streptococcus pneumoniae and Klebsiella pneumoniae were the main pathogenic bacteria in babyhood,and Streptococcus pneumoniae were the main pathogenic bacteria in infancy and pre-school age.The five main pathogenic bacteria were mainly distributed in infancy,and their isolation rates among pediatric patients≤28 days,29 days to 1 year old,1-3 years old and 3-7 years old were statistically significant(χ^(2)=57.92,P=0.000<0.05).The resistance rate of Streptococcus pneumoniae to erythromycin,clindamycin,cefuroxime and tetracycline was more than 75%,the resistance rate to compound sulfamethoxazole was more than 38%,and it had strong sensitivity to penicillin,amoxicillin/clavulanic acid,ceftriaxone,meropenem,levofloxacin,vancomycin and linezolid(the resistance rate was less than 7.7%).Except for one case in infancy and one in preschool period,other Klebsiella pneumoniae was resistant to cefuroxime,cefoxitin,compound sulfamethoxazole and chloramphenicol(10%≤drug resistance rate≤30%),had a strong sensitivity to ceftazidime,cefepime,β-lactam mixtu

关 键 词：小儿社区 获得性下呼吸道感染 病原菌分布及耐药性 年龄 

分 类 号：R378[医药卫生—病原生物学]