2019—2023年小儿下呼吸道肺泡灌洗液病原学特征  

Etiological Characteristics of Alveolar Lavage Fluid of Lower Respiratory Tract in Children from 2019 to 2023

作　　者：张晓燕 冯博文 程伟远 ZHANG Xiaoyan;FENG Bowen;CHENG Weiyuan(Department of Pediatrics,Xuchang Central Hospital,Xuchang 461000,China)

机构地区：[1]许昌市中心医院儿科一病区,河南许昌461000

出　　处：《河南医学研究》2025年第7期1248-1252,共5页Henan Medical Research

摘　　要：目的分析2019—2023年小儿下呼吸道肺泡灌洗液病原学特征。方法回顾性分析2019年1月至2023年6月许昌市中心医院细菌室接收的小儿下呼吸道肺泡灌洗液分离出的致病菌株787例以及病毒株489例,全部研究对象均采集肺泡灌洗液并将标本送医院细菌室进行病原培养与鉴定,通过查阅患儿病历资料结合医院信息系统等方式收集肺泡灌洗液的检测结果,并对其病原学特征进行分析。结果在787株致病菌中,菌株占比最高的致病菌类型分别为肺炎链球菌、肺炎支原体以及流感嗜血杆菌,占比分别为31.64%、19.06%以及12.58%;在肺泡灌洗液中检出的489例病毒株中,占比最高的是甲型/乙型流感病毒、呼吸道合胞病毒以及人偏肺病毒,占比分别为30.47%、22.90%以及22.29%;在检出率最高的肺炎链球菌以及肺炎支原体病株中,肺炎链球菌对红霉素、复方新诺明以及四环素的耐药率最高,分别为84.09%、82.79%以及77.91%;对头孢噻肟、万古霉素以及左氧氟沙星的耐药率最低,分别为2.81%、0.80%以及0.42%;与此同时,肺炎支原体对红霉素、克拉霉素、罗红霉素的耐药率均超过了30.00%;对交沙霉素的耐药率相对较低,为14.49%。结论在许昌市中心医院小儿下呼吸道肺泡灌洗液检出的常见病原中,肺炎链球菌以及肺炎支原体的占比最高。耐药情况的检测结果显示,部分常用抗生素对病菌耐药率不容乐观,医务人员需尤其注意规范抗生素药物的使用,加强对患儿的用药指导,以避免耐药情况的进一步恶化。Objective To analyze the etiological characteristics of alveolar lavage fluid of lower respiratory tract in children from 2019 to 2023.Methods Retrospective analysis was performed on 787 cases of pathogenic strains and 489 cases of viral strains isolated from alveolar lavage fluid of children’s lower respiratory tract received in the bacteria room of Xuchang Central Hospital from January 2019 to June 2023.Alveolar lavage fluid was collected from all subjects and specimens were sent to the bacteria room of our hospital for pathogen culture and identification.The detection results of alveolar lavage fluid were collected by means of patient data and hospital information system,and its etiological characteristics were analyzed.Results Among the 787 pathogenic bacteria,Streptococcus pneumoniae,Mycoplasma pneumoniae and Haemophilus influenzae accounted for 31.64%,19.06%and 12.58%,respectively.Among 489 virus strains detected in alveolar lavage fluid,the highest proportion were influenza A virus/influenza B virus,respiratory syncytial virus and human metapneumovirus,accounting for 30.47%,22.90%and 22.29%,respectively.Among Streptococcus pneumoniae and Mycoplasma pneumoniae strains with the highest detection rates,Streptococcus pneumoniae had the highest resistance rates to erythromycin,cotrimoxazole and tetracycline,which were 84.09%,82.79%and 77.91%,respectively.The resistance rates to cefotaxime,vancomycin and levofloxacin were the lowest,which were 2.81%,0.80%and 0.42%,respectively.At the same time,the resistance rate of Mycoplasma pneumoniae to erythromycin,clarithromycin and roxithromycin exceeded 30.00%.The drug resistance rate was 14.49%,which was relatively low.Conclusion Streptococcus pneumoniae and Mycoplasma pneumoniae accounted for the highest proportion among common pathogens detected by alveolar lavage fluid of small respiratory tract in children in Xuchang Central Hospital.The test results of drug resistance showed that the resistance rate of some commonly used antibiotics was not optimistic.Medical sta

关 键 词：下呼吸道肺泡灌洗液 病原学特征 菌株耐药性 

分 类 号：R446.5[医药卫生—诊断学]