成人与儿童下呼吸道感染患者的病原菌分布及耐药性分析  

Pathogen Distribution and Drug Resistance Analysis of Adults and Children with Lower Respiratory Tract Infections

作　　者：吴建武[1] 鄢能荣 廖汉杰 WU Jianwu;YAN Nengrong;LIAO Hanjie(Department of Pediatrics,Shenzhen Bao'an District Shiyan People's Hospital,Shenzhen,Guangdong 518108)

机构地区：[1]深圳市宝安区石岩人民医院儿科,广东深圳518108

出　　处：《智慧健康》2024年第23期5-8,12,共5页Smart Healthcare

摘　　要：目的分析不同年龄段下呼吸道感染患者的病原菌检测结果及耐药特征。方法将本院2019年7月—2022年7月收治的120例下呼吸道感染患者纳入研究,其中儿童(4~14岁)共50例,成人(18~65岁)共70例,对其进行痰液分泌物检测,观察病原菌分布,选取应用较为广泛的几种抗生素,分析耐药性。结果在成人下呼吸道感染的病原菌中,革兰阴性菌所占比例为74.0%,而革兰阳性菌所占比例为17.5%。在儿童下呼吸道感染的病原菌中,革兰阴性菌所占比例为70.0%,革兰阳性菌所占比例为23.0%。针对下呼吸道感染患者革兰阴性菌的耐药性分析显示,在成人患者中,肺炎克雷伯菌对氨曲南、头孢哌酮、头孢曲松、头孢唑林等药物的耐药率超过50.0%,而对其他药物的耐药率相对较低。铜绿假单胞菌对阿莫西林/克拉维酸、氨曲南、头孢哌酮等药物的耐药率超过50%,而对其他药物的耐药率较低。在儿童群体中,肺炎克雷伯菌和大肠埃希菌对头孢哌酮的耐药率超过50.0%,而对其他药物的耐药率相对较低。针对下呼吸道感染患者中革兰阳性菌的耐药性分析显示,在成人患者中,金黄色葡萄球菌对头孢唑林和左氧氟沙星的耐药率超过50.0%,而肺炎链球菌仅对头孢唑林的耐药率超过50.0%。儿童中,金黄色葡萄球菌和肺炎链球菌对头孢唑林的耐药率均超过50.0%,而对其他药物的耐药率则较低。结论成人及儿童感染的病原菌类型及耐药情况有一定的差异,通过对这些因素的研究,可帮助临床医师针对不同人群开展针对性用药,保证良好的疗效。Objective To analyze pathogen detection results and drug resistance characteristics of patients with lower respiratory tract infections of different age groups.Methods The paper chose 120 patients with lower respiratory tract infections in our hospital from July 2019 to July 2022 for study,including 50 children(4~14 years old)and 70 adults(18~65 years old).Sputum secretion was detected to observe distribution of pathogens,drug resistance was analyzed based on several widely used antibiotics.Results Among main pathogenic bacteria detected in adult lower respiratory tract infections,Gram negative bacteria accounted for 74.0%and Gram positive bacteria accounted for 17.5%.Among main pathogens of lower respiratory tract infections of children,Gram negative bacteria accounted for 70.0%and Gram positive bacteria accounted for 23.0%.Resistance analysis of main Gram negative bacteria of patients with lower respiratory tract infections showed,drugs with resistance exceeding 50.0%in Klebsiella pneumoniae for adults included Amtrazumab,Cefoperazone,Ceftriaxone and Ceftazolin,while other drugs had lower resistance.Drugs with resistance rate of over 50.0%in Pseudomonas aeruginosa included amoxicillin/clavulanic acid,amtreonam and cefoperazone,while other drugs had lower resistance.Only cefoperazone had drug resistance exceeding 50.0%for Klebsiella pneumoniae and Escherichia coli for children,while other drugs had lower resistance.Among patients with lower respiratory tract infections,cefazolin and levofloxacin had more than 50.0%resistance for staphylococcus aureus for adults,while only cefazolin had resistance exceeding 50.0%for streptococcus pneumoniae.Cefazolin had more than 50.0%resistance for Staphylococcus aureus and Streptococcus pneumoniae for children,and other drugs had lower resistance.Conclusion Analysis of patients with different lower respiratory tract infections shows,there is some certain difference in types of pathogens and drug resistance between adults and children.Study of these factors can help clinical ph

关 键 词：成人 儿童 下呼吸道感染 病原菌分布 耐药性 

分 类 号：R446.5[医药卫生—诊断学]