小儿细菌性肺炎痰培养物的病原菌构成及耐药性分析  

Analysis of pathogenic bacteria composition and drug resistance in sputum culture of children with bacterial pneumonia

作　　者：赵仙华 袁支胜 钱云芳 ZHAO Xianhua;YUAN Zhisheng;QIAN Yunfang(Department of Laboratory,Danyang Maternal and Child Health Care Hospital,Jiangsu Province,Danyang 212300,China)

机构地区：[1]江苏省丹阳市妇幼保健院检验科,江苏丹阳212300

出　　处：《妇儿健康导刊》2023年第21期85-88,共4页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：目的分析小儿细菌性肺炎痰培养物的病原菌构成及耐药性。方法选择丹阳市妇幼保健院2021年1月至2023年5月收治的200例细菌性肺炎患儿,均采集痰液标本进行细菌培养,对阳性标本开展细菌鉴定,分析其耐药性。结果200例细菌性肺炎患儿分离病原菌200株,革兰氏阴性菌占比73.50%,其中大肠埃希菌21.00%、肺炎克雷伯菌17.50%、铜绿假单胞菌12.50%、鲍曼不动杆菌10.50%、阴沟肠杆菌9.00%、其他3.00%;革兰氏阳性菌占比26.50%,其中金黄色葡萄球菌15.00%、肺炎链球菌9.00%、其他2.50%。大肠埃希菌对环丙沙星、亚胺培南、阿卡米星的耐药率低于10%,肺炎克雷伯菌对环丙沙星、亚胺培南的耐药率低于20%,铜绿假单胞菌对亚胺培南、环丙沙星、头孢吡肟的耐药率低于20%。金黄色葡萄球菌对左氧氟沙星、万古霉素的耐药率为0%。肺炎链球菌对头孢他啶、头孢噻肟、头孢呋辛、头孢西丁、头孢吡肟、左氧氟沙星、苯唑西林、万古霉素的耐药率为0%。结论小儿细菌性肺炎常见革兰氏阴性菌感染,不同病原菌对常用抗菌药物的耐药性不同,临床应根据药敏实验结果合理选用抗菌药物。Objective To analyze the pathogenic bacteria composition and drug resistance in sputum culture of children with bacterial pneumonia.Methods A total of 200 children with bacterial pneumonia admitted to Danyang Maternal and Child Health Hospital from January 2021 to May 2023 were selected.Sputum samples were collected from all children for bacterial culture,and positive samples were identified and their drug resistance was analyzed.Results A total of 200 strains of pathogenic bacteria were isolated from 200 children with bacterial pneumonia,of which Gram-negative bacteria accounted for 73.50%,including Escherichia coli 21.00%,Klebsiella pneumoniae 17.50%,Pseudomonas aeruginosa 12.50%,Acinetobacter baumannii 10.50%,Enterobacter cloacae 9.00%,and others 3.00%.Gram-positive bacteria accounted for 26.50%,of which Staphylococcus aureus 15.00%,Streptococcus pneumoniae 9.00%,and others 2.50%.The resistance rate of Escherichia coli to Ciprofloxacin,Imipenem and Amikacin was less than 10%,the resistance rate of Klebsiella pneumoniae to Ciprofloxacin and Imipenem was less than 20%,and the resistance rate of Pseudomonas aeruginosa to Imipenem,Ciprofloxacin and Cefepime was less than 20%.The resistance rate of Staphylococcus aureus to Levofloxacin and Vancomycin was 0%.The resistance rate of Streptococcus pneumoniae to Ceftazidime,Cefotaxime,Cefuroxime,Cefoxitin,Cefepime,Levofloxacin,Oxacillin and Vancomycin was 0%.Conclusion Gram-negative bacteria are common in children with bacterial pneumonia.Different pathogens have different drug resistance to commonly used antibiotics.Clinical use of antibiotics should be based on the results of drug sensitivity test.

关 键 词：小儿细菌性肺炎 痰培养 耐药性 革兰氏阴性菌 革兰氏阳性菌 

分 类 号：R725[医药卫生—儿科]