2018-2021年焦作市儿童下呼吸道感染病原菌谱及耐药性分析  

Bacteriologic Profile and Drug Resistance in Children with Lower Respiratory Tract Infection of Jiaozuo City from 2018 to 2021

作　　者：郑丽丽[1] 马卫东[1] 桂静 杨雪雯[1] 王盈红[1] Zheng Lili;Ma Weidong;Gui Jing;Yang Xuewen;Wang Yinghong(The People’s Hospital of Jiaozuo City,Henan Jiaozuo 454002,China)

机构地区：[1]焦作市人民医院,河南焦作454002

出　　处：《儿科药学杂志》2023年第3期39-44,共6页Journal of Pediatric Pharmacy

摘　　要：目的:调查焦作市儿童下呼吸道感染(LRTI)病原菌种类、分布特点和耐药情况,为指导儿科临床用药及感染性疾病控制提供证据。方法:对2018-2021年于焦作市人民医院就诊的社区获得性LRTI患儿的痰液样本进行细菌分离培养,通过ATB细菌鉴定及药敏分析仪对细菌进行鉴定和耐药性分析。结果:从5493份送检的样本中共检出阳性样本952份(17.33%),分离出1092株病原菌,包括415株(38.00%)革兰阳性菌、655株(59.98%)革兰阴性菌和22株(2.01%)真菌。检出最多的革兰阳性菌为肺炎链球菌(32.69%)和金黄色葡萄球菌(3.94%);最常见的革兰阴性菌为流感嗜血杆菌(26.56%)和肺炎克雷伯菌(22.80%);真菌以白色念珠菌(1.28%)和光滑念珠菌(0.55%)常见。革兰阳性菌和肺炎链球菌检出率总体呈逐年升高的趋势(P<0.05),且在春季和冬季检出率较高。共发现107例混合感染。肺炎链球菌和金黄色葡萄球菌对万古霉素和环丙沙星较敏感,对阿奇霉素的耐药率较高;流感嗜血杆菌和肺炎克雷伯菌对氨苄西林和阿莫西林的敏感性较低,对其他抗菌药物均有一定敏感性。结论:焦作市儿童LRTI病原菌以肺炎链球菌、流感嗜血杆菌和肺炎克雷伯菌为主,存在混合感染的可能性,应根据病原菌的耐药性制定合理用药方案,规范抗菌药物使用。Objective:To study the bacteriologic profile and drug resistance of lower respiratory tract infection(LRTI)in children of Jiaozuo City,and to provide clues for guiding pediatric clinical medication and infectious diseases control.Methods:Sputum samples from children with community-acquired LRTI attending Jiaozuo People’s Hospital from 2018 to 2021 were isolated and cultured for bacterial identification.The bacterial identification and drug resistance analysis were performed by ATB bacterial identification and drug sensitivity analyzer.Results:A total of 952 positive samples(17.33%)were detected from 5,493 samples.A total of 1,092 pathogenic strains were isolated,including 415 gram-positive strains(38.00%),655 gram-negative strains(59.98%)and 22 fungal strains(2.01%).The most frequently detected gram-positive organisms were Streptococcus pneumoniae(32.69%)and Staphylococcus aureus(3.94%);the most common gram-negative organisms were Haemophilus influenzae(26.56%)and Klebsiella pneumoniae(22.80%);Candida albicans(1.28%)and Candida smoothus(0.55%)were the most common fungal strains.The detection rate of gram-positive bacteria and Streptococcus pneumoniae generally showed a year-on-year increase trend(P<0.05)and was higher in spring and winter,with 107 cases of mixed infections identified.Streptococcus pneumoniae and Staphylococcus aureus were more sensitive to vancomycin and ciprofloxacin,with a resistance to azithromycin;Haemophilus influenzae and Klebsiella pneumoniae were less susceptible to ampicillin and amoxicillin,showing somewhat susceptibility to all other antibiotics.Conclusion:The pathogens of LRTI in children of Jiaozuo City are mainly Streptococcus pneumoniae,Haemophilus influenzae and Klebsiella pneumoniae.There is a possibility of mixed infections.A rational and standardized antibiotic drug regimen should be formulated according to the drug resistance of the pathogens.

关 键 词：儿童 下呼吸道感染 病原菌谱 耐药性 

分 类 号：R725.6[医药卫生—儿科]