儿童细菌性肺炎感染病原谱及对抗菌药物耐药性分析  

Pathogen Spectrum and Drug Resistance of Bacterial Pneumonia in Children

作　　者：付美林 陈兰兰 吴欢 倪新黔 FU Meilin;CHEN Lanlan;WU Huan;NI Xinqian(Guiyang Second People’s Hospital,Guiyang 550081,China;Wudang District People’s Hospital of Guiyang City,Guiyang 550018,China;Xiuwen County People’s Hospital,Xiuwen 550200,China;General Medical 300 Hospital,Guiyang 550009,China)

机构地区：[1]贵阳市第二人民医院/贵州医科大学附属金阳医院,贵州贵阳550081 [2]贵阳市乌当区人民医院,贵州贵阳550018 [3]修文县人民医院,贵州修文550200 [4]通用医疗三零零医院,贵州贵阳550009

出　　处：《生物化工》2024年第2期29-33,共5页Biological Chemical Engineering

摘　　要：目的:探讨某地区儿童细菌性肺炎感染病原谱及耐药性,为该地区儿童细菌性肺炎的治疗提供参考依据。方法:收集2022年1—12月某地区三甲医院细菌性肺炎患儿下呼吸道标本进行细菌培养和药敏试验,分析不同性别儿童病原菌检出差异性。结果:共检出481株病原菌,革兰阴性菌259株,占53.8%;革兰阳性菌222株,占46.2%。感染常见的前4位细菌是卡他莫拉菌、金黄色葡萄球菌、肺炎链球菌和流感嗜血杆菌。男性儿童以卡他莫拉菌检出占首位,女性儿童以金黄色葡萄球菌检出占首位,不同性别主要病原菌的检出无差异性(p>0.05)。金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)占28.8%,对青霉素的耐药率高达82.6%,肺炎链球菌对四环素、克林霉素和红霉素均100%耐药,未检出对万古霉素和利奈唑胺耐药菌株。卡他莫拉菌和流感嗜血杆菌中β-内酰胺酶阳性检出率分别为88.3%和74.4%,卡他莫拉菌对克林霉素的耐药率最高(92.0%),流感嗜血杆菌对氨苄西林的耐药率最高(79.5%)。结论:该地区儿童细菌性肺炎感染的常见病原菌是卡他莫拉菌、金黄色葡萄球菌、肺炎链球菌和流感嗜血杆菌,不同病原菌对同种抗菌药物的耐药率相差较大。本研究为该地区儿童细菌性肺炎的治疗提供了参考依据。Objective:To investigate the pathogenic spectrum and drug resistance of bacterial pneumonia in children in an area,and to provide a reference for the treatment of bacterial pneumonia in children in this area.Methods:The lower respiratory tract samples of children with bacterial pneumonia from January 2022 to December 2022 in a Grade 3A hospital in a region are collected for bacterial culture and drug sensitivity test.The difference of pathogenic bacteria detection in children of different sexes is analyzed.Results:A total of 481 strains of pathogenic bacteria are detected,259 strains of Gram negative bacteria,accounting for 53.8%;222 strains of Gram positive bacteria,accounting for 46.2%.The top four bacteria commonly infected are Moraxella catarrhalis,Staphylococcus aureus,Streptococcus pneumoniae and Haemophilus influenzae.The detection of Moraxella catarrhalis is the first in male children,and Staphylococcus aureus is the first in female children.There is no difference in the detection of major pathogens between different sexes(p>0.05).Methicillin-resistant staphylococcus aureus(MRSA)accounted for 28.8%of Staphylococcus aureus,and the resistance rate to penicillin is as high as 82.6%.Streptococcus pneumoniae is 100%resistant to tetracycline,clindamycin and erythromycin,and no vancomycin and linezolid resistant strains are detected.The positive rates ofβ-lactamase in Moraxella catarrhalis and Haemophilus influenzae are 88.3%and 74.4%,respectively.The resistant rate of Moraxella catarrhalis to clindamycin is 92.0%,and the resistant rate of Haemophilus influenzae to ampicillin is 79.5%.Conclusion:The common pathogens of children’s bacterial pneumonia infection in this area are Moraxella catarrhalis,Staphylococcus aureus,Streptococcus pneumoniae and Haemophilus influenzae,and the drug resistance rate of different pathogens to the same antibiotic varies greatly.This study provides a reference for the treatment of children’s bacterial pneumonia in this area.

关 键 词：儿童 细菌性肺炎 病原菌 抗菌药物 耐药性 

分 类 号：R183.3[医药卫生—流行病学] R725.6[医药卫生—公共卫生与预防医学]