院内下呼吸道感染患儿细菌分布及细菌药敏情况分析  

Analysis of Bacterial Distribution and Bacterial Drug Susceptibility in Children With Nosocomial Lower Respiratory Tract Infection

作　　者：熊义兴 吴华美 陈新 XIONG Yixing;WU Huamei;CHEN Xin(Department of Laboratory,Nanping Maternal and Child Health Hospital,Nanping Fujian 353000,China)

机构地区：[1]福建省南平市妇幼保健院检验科,福建南平353000

出　　处：《中国卫生标准管理》2022年第24期22-26,共5页China Health Standard Management

摘　　要：目的对痰培养阳性院内下呼吸道感染患儿的病原菌分布情况进行了解,并分析细菌药敏情况。方法选择2021年2月—2022年2月福建省南平市妇幼保健院儿科收治的下呼吸道感染患儿189例为研究对象,对入选患儿进行痰培养试验,应用药敏分析系统读数仪(DL96A)将病原菌进行鉴定,分析药敏结果。结果189例患儿中,病原菌检出率为60.85%.115株病原菌中,56.52%为革兰阴性杆菌,其中肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌分别为46.15%、27.69%、15.38%。革兰阳性球菌所占比为21.74%及真菌所占比为21.74%,革兰阳性球菌包括菌群为金黄色葡萄球菌与凝固阴性葡萄球菌等。白色假丝酵母菌是真菌的主要类型。革兰阴性杆菌包括肺炎克雷伯菌与大肠埃希菌两类,第一类菌群对头孢他啶具有较高的耐药性,耐药率为33.33%;肺炎克雷伯菌对亚胺培南的耐药性最低,耐药率为6.67%;而大肠埃希菌对阿米卡星(55.56%)、头孢他啶(55.56%)、头孢曲松(50.00%)等药物的耐药性较高,而对亚胺培南的耐药性最低,耐药率为5.56%。金黄色葡萄球菌对青霉素表现出较高的耐药性,耐药率为100%,而凝固酶阴性葡萄球菌对庆大霉素(50.00%)、青霉素(50.00%)、环丙沙星(50.00%)等药物的耐药性较高。结论革兰阳性球菌、革兰阴性杆菌是儿科下呼吸道感染的主要致病菌,对致病菌进行痰培养及药敏试验对临床安全用药具有指导意义。Objective To understand the distribution of pathogenic bacteria in children with nosocomial lower respiratory tract infection with positive sputum culture,and analyze the drug sensitivity of bacteria.Methods A total of189 Children with lower respiratory tract infection from February 2021 to February 2022 in Nanping Maternal and Child Health Hospital,Fujian Province were selected as the research object.Sputum culture test was carried out on the selected children,and the pathogens were identified by drug sensitivity analysis system reader(DL96A),and the drug sensitivity results were analyzed.Results Among 189 children,the detection rate was 60.85%;among 115 pathogens,56.52%were gram-negative bacteria.Among them,Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa accounted for 46.15%,27.69%and 15.38%respectively.21.74%were gram-positive bacteria,and S.white(21.74%).Gram-positive bacteria were mainly K.pneumoniae and E.coli,among which K.pneumoniae had the highest resistance to ceftazidime,33.33%,K.pneumoniae to 6.67%.The resistance of Escherichia coli to amikacin(55.56%),ceftazidime(55.56%)and ceftriaxone(50.00%)was higher,while the resistance to imipenem was the lowest,with a resistance rate of 5.56%.Staphylococcus aureus showed resistance to penicillin High drug resistance,the drug resistance rate is 100%.Conclusion Gram-positive bacteria and Gram-negative bacteria are the main pathogenic bacteria of nosocomial lower respiratory tract infection.The sputum culture and drug susceptibility test of pathogenic bacteria have guiding significance for clinical safe drug use.

关 键 词：痰培养阳性 下呼吸道感染 细菌分布 药敏情况 病原菌 耐药率 

分 类 号：R378[医药卫生—病原生物学]