广州某医院儿童社区获得性肺炎病原菌分布及耐药性分析  

Distribution and drug resistance of pathogenic bacteria in childrenwith community-acquired Pneumonia in a hospital in Guangzhou

作　　者：刁福强 罗欣[1] 古春明 唐玲玲[1] Diao Fuqiang;Luo Xin;Gu Chunming;Tang Lingling(Department of Clinical Laboratory,Guangdong Maternal and Child Health Hospital,Guangzhou Guangdong 511400,China)

机构地区：[1]广东省妇幼保健院检验科,广东广州511400

出　　处：《中华临床实验室管理电子杂志》2023年第1期38-44,共7页Chinese Journal of Clinical Laboratory Management(Electronic Edition）

摘　　要：目的:分析2017-2019年广州某医院儿童社区获得性肺炎(CAP)病原菌分布及耐药情况,为CAP诊疗提供参考与帮助。方法:回顾性分析2017年1月至2019年12月广东省妇幼保健院收治并检出病原菌的1686例CAP患者的病原学资料,依据患者的年龄、性别、季节分组,应用SPSS 20.0及Whonet软件对上述资料进行分析。结果:CAP发病季节以春季为主,占32.7%,患病年龄在1~6月占72.4%;各年龄段主要致病菌如下,1~6月患儿为大肠埃希菌(18.7%)、肺炎克雷伯菌(16.5%)、金黄色葡萄球菌(15.6%);7~12月患儿为肺炎链球菌(20.7%)、流感嗜血杆菌(20.7%);1~3岁患儿易感染肺炎链球菌(23.1%)。对于6种主要的病原菌,除万古霉素外,各种抗菌药物均存在不同程度的耐药情况。细菌3年间对大多数药物耐药情况总体变化不大,只有个别药物耐药率差异有统计学意义(P<0.05)。结论:广州地区儿童CAP病原菌在不同年龄段和不同季度间分布存在差异,个别药物出现耐药率变化,应重视和加强儿童CAP病原学、流行病学的监测及临床特征研究。Objective To analyze the distribution and drug resistance of pathogenic bacteria in children with community-acquired pneumonia(CAP)in a hospital in Guangzhou from 2017 to 2019,and to improve the clinical treatment of children with CAP.Methods The etiological data of 1686 children with CAP admitted to Guangdong Maternal and Child Health Hospital from January 2017 to December 2019 were retrospectively analyzed.According to age,gender and season,the above data were analyzed by SPsS 20 and WHONET software.Results The incidence of CAP was mainly in spring(32.7%),and the incidence rate of children in 1 to 6 months was higher(72.4%).The main pathogens in different age groups were as follows:Escherichia coli(18.7%),Klebsiella pneumoniae(16.5%),and Staphylococcus aureus(15.6%)in children aged 1 to 6 months;children aged 7 to 12 months were susceptible to Streptococcus pneumoniae(20.7%)and Haemophilus influenzae(20.7%);and children aged 1 to 3 years were susceptible to Streptococcus pneumoniae(23.1%).In addition to vancomycin,all kinds of antibiotics were resistant to the 6 main pathogens to varying degrees.There was litle overall change in bacterial resistance to most drugs during the three years,and only the differences in the resistance rates of individual drugs were statistically significant(P<0.05).Conclusions The distribution of CAP pathogens in children in Guangzhou was different between different ages and different quarters,and the drug resistance rate of individual drugs changed.Therefore,attention should be paid to the monitoring of etiological epidemiology and clinical characteristics of CAPin children.

关 键 词：儿童 社区获得性肺炎 耐药性 细菌 

分 类 号：R446.5[医药卫生—诊断学] R563.1[医药卫生—临床医学]