2018—2020年住院患儿呼吸道感染病原菌的特点及耐药性分析  

Characteristics and drug resistance profile of pathogenic bacteria isolated from hospitalized children with respiratory tract infection from 2018 to 2020

作　　者：彭善鑫 孙志清[1] 朱晓松 左志文[1] 卓凤娟 PENG Shanxin;SUN Zhiqing;ZHU Xiaosong;ZUO Zhiwen;ZHUO Fengjuan(Department of Hospital Infection Management,Linyi People's Hospital,Shandong Province,Linyi 276000,China)

机构地区：[1]山东省临沂市人民医院医院感染管理部,山东临沂276000

出　　处：《中国当代医药》2022年第35期148-151,共4页China Modern Medicine

基　　金：山东省临沂市人民医院博士科研创新(启动)基金项目(2019LYBS09)。

摘　　要：目的分析住院患儿呼吸道感染病原菌特点及耐药性。方法选取2018—2020年临沂市人民医院(以下简称“本院”)住院患儿下呼吸道标本中分离的2324株病原菌,经质谱仪鉴定联合微量肉汤稀释法和纸片扩散法进行药敏试验。结果2324株病原菌中,流感嗜血杆菌、金黄色葡萄球菌、肺炎克雷伯菌位列前三。其中,男性患儿的肺炎克雷伯菌检出率高于女性患儿,差异有统计学意义(P<0.05)。≤1岁患儿的流感嗜血杆菌检出率低于>1岁患儿,肺炎克雷伯菌检出率高于>1岁患儿,差异有统计学意义(P<0.05)。2020年本院流感嗜血杆菌对阿莫西林克拉维酸钾(AMC)的耐药率高于2018、2019年,差异有统计学意义(P<0.05),2018年和2019年本院流感嗜血杆菌对AMC的耐药率比较,差异无统计学意义(P>0.05)。结论本院儿童下呼吸道标本检出菌以革兰氏阴性菌为主,其中流感嗜血杆菌最多,其在≤1岁患儿中的检出率低于>1岁患儿;≤1岁患儿肺炎克雷伯菌的检出率高于>1岁患儿,男性患儿肺炎克雷伯菌的检出率高于女性患儿。不同病原菌有不同程度的耐药性,因此临床医师应在经验性用药之前,尽快送检患儿疑似感染部位的标本,并根据药敏试验结果选择敏感抗生素及时进行治疗。Objective To investigate the distribution characteristics and drug resistance profile of the common pathogens isolated from hospitalized children with lower respiratory infection.Methods A total of 2324 common pathogen strains were isolated from lower respiratory tract specimens of hospitalized children in Linyi People's Hospital from 2018 to 2020.The drug sensitivity test was carried out by mass spectrometer and microbroth dilution method and disk diffusion method.Results Among 2324 pathogenic strains,Haemophilus influenzae,Staphylococcus aureus and Klebsiella pneumoniae were the top three.The detection rate of Klebsiella pneumoniae in male children was higher than that in female children,the difference was statistically significant(P<0.05).The detection rate of Haemophilus influenzae in≤1 year old children was lower than that in>1 year old children,while the detection rate of Klebsiella pneumoniae in≤1 year old children was higher than that in>1 year old children,the differences were statistically significant(P<0.05).The drug resistance rate of Haemophilus influenzae to Amoxicillin Clavulanate Potassium(AMC)in 2020 was higher than that in 2018 and 2019,and the difference was statistically significant(P<0.05).There was no significant difference in the drug resistance rate of Haemophilus influenzae against AMC between 2018 and 2019(P>0.05).Conclusion Gram-negative bacteria were the main bacteria detected in children's lower respiratory tract samples,of which Haemophilus influenzae was the most common.And its detection rate in children≤1 year old was lower than that in children>1 year old.The detection rate of Klebsiella pneumoniae in children≤1 years old was higher than that in children>1 years old,and the detection rate in male children was higher than that in female children.Due to different pathogenic bacteria have different features of drug resistance,clinicians should send the implicated specimen to isolate pathogen as soon as possible before empirical antibiotic treatment and select active antibioti

关 键 词：下呼吸道感染 病原细菌 耐药性 儿童 

分 类 号：R446.5[医药卫生—诊断学]