276例住院患儿下呼吸道病原菌分布及耐药性分析  

Distribution and drug resistance of pathogenic bacteria in lower respiratory tract of 276 hospitalized children

作　　者：钱璐璐 孙雪梅 黄秋香 刘剑平[1] 李君召[1] QIAN Lulu;SUN Xuemei;HUANG Qiuxiang;LIU Jianping;LI Junzhao(Department of Pediatrics,Taizhou People′s Hospital,Taizhou,Jiangsu 225300,China)

机构地区：[1]江苏省泰州市人民医院儿科,江苏泰州225300

出　　处：《公共卫生与预防医学》2023年第5期137-140,共4页Journal of Public Health and Preventive Medicine

摘　　要：目的 针对泰州市人民医院276例住院患儿下呼吸道感染病原菌流行病学特征及耐药性进行分析和讨论,以利预防和诊治。方法 研究分析该院2019年1月至2021年12月间就诊的住院患儿中出现下呼吸道感染的276名患儿进行分析。研究收集并分析病原菌的分布特点;同时收集耐药情况信息,简单讨论病原菌分布与耐药性之间的潜在关联。结果 全部276例患者共送检血液标本检出病原菌共532株,主要革兰阳性菌(207株):其中金黄色葡萄球菌104株,表皮葡萄球菌96株,其他7株;革兰阴性菌(325株)为克雷伯172株,大肠埃希菌153株。分别统计不同性别和年龄段(5岁以下,5~10岁,10~14岁)病原菌分布可见,5岁以下女性患儿(n=49例)病原菌分布具有不同于合计人群的特点:革兰阳性菌感染高于革兰阴性菌,其中以表皮葡萄球菌所占比例最高(P<0.05)。其他年龄和性别患儿分布特征与合计分布特征一致。革兰阳性菌对青霉素、红霉素及克拉霉素的耐药率较高;革兰阴性菌对氨苄西林、头孢唑林及头孢呋辛的耐药率较高。不同性别和年龄段患儿中分布特征一致。结论 儿科病房下呼吸道感染患儿病原菌主要以革兰阴性菌为主,且主要病原菌对常见药物的耐药率较高,其中5岁以下女性患儿病原菌分布具特异性:革兰阳性菌感染高于革兰阴性菌,其中以表皮葡萄球菌所占比例最高,值得关注。临床可以药敏试验可作为治疗用药的重要参考依据,以利指导合理选择抗菌药物。Objective To analyze the epidemiological characteristics and drug resistance of pathogenic bacteria in 276 hospitalized children with lower respiratory tract infection to facilitate prevention and treatment.Methods Among of 276 hospitalized children with lower respiratory tract infection from January 2019 to December 2021 were analyzed.Data on the distribution of pathogenic bacteria were collected and analyzed.At the same time,the information on drug resistance was collected,and the potential relationship between pathogen distribution and drug resistance was briefly analyzed and discussed.Results A total of 532 strains of pathogenic bacteria were detected in the blood samples from 276 patients in this study.There were 207 strains of Gram-positive bacteria,including 104 strains of staphylococcus aureus,96 strains of staphylococcus epidermidis and 7 strains of others.Gram negative bacteria(325 strains)were 172 strains of Klebsiella and 153 strains of escherichia coli.The distribution of pathogenic bacteria in different gender and age groups(under 5 years old,5-10 years old,and over 10-14 years old)was calculated separately.The results showed that the distribution of pathogenic bacteria in female children under 5 years old(n=49 cases)was different from the total population:the infection of Gram-positive bacteria was higher than that of Gram-negative bacteria,and the proportion of staphylococcus epidermidis was the highest(P<0.05).The distribution characteristics of children of other ages and sexes were consistent with the total distribution characteristics.The resistance rate of Gram-positive bacteria to penicillin,erythromycin and clarithromycin was high,while the resistance rate of Gram-negative bacteria to ampicillin,cefazolin and cefuroxime was high.The distribution characteristics were the same in children of different sex and age.Conclusion The pathogenic bacteria in children with lower respiratory tract infection in pediatric ward are mainly Gram-negative bacteria,and the main pathogenic bacteria have a high

关 键 词：住院患儿 下呼吸道感染 病原菌 耐药性 

分 类 号：R181[医药卫生—流行病学]