2010-2012年度儿童下呼吸道感染的病原菌及耐药性分析

目的 探讨儿童下呼吸道感染的病原学特点及药物敏感性,指导临床合理使用抗生素.方法 2010年10月-2012年11月间在该院儿科住院的下呼吸道感染的呼吸道分泌物标本中分离病原菌并进行药物敏感性监测.结果 614份呼吸道分泌物标本中共分离出105株病原菌,阳性率为17.11％,其中G-菌73株,占69.52％,G＋球菌32株,占30.48％.革兰阴性菌中,第3位分别为大肠埃希菌26株（占35.62％）,肺炎克雷伯菌23株（31.51％）,流感嗜血杆菌11株（15.07％）.革兰阳性菌中金色葡萄球菌感染率最高.G-菌对阿米卡星、亚胺培南、哌拉西林/他唑巴坦均敏感.G＋菌耐药率低,头孢类抗生素普遍敏感.结论 该地区儿童下呼吸道感染的病原菌以G-菌为主,且对常用抗生素有不同程度的耐药,提醒临床医生应依据药敏试验结果合理选择抗菌药物.

Analysis of Pathogenic Bacteria and Drug Resistance of Children with Lower Respiratory Tract Infection from 2010 to 2012

Objective To investigate the etiology of children with lower respiratory tract infection and drug resistance to antibiotics so as to provide a guidance for reasonable use of drugs in clinical practice. Methods Pathogenic bacteria were isolated from spec- imens of sputum of children with lower respiratory tract infection admitted in Department of Paediatrics of our hospital from Octo- ber, 2010 to November 2012 and drug sensitivity was tested. Results A total of 105 strains of bacteria were isolated from 614 sam- pies, the positive rate was 17.11%. Of which, Gram-negative bacteria was the major pathogenic bacteria （73 strains, 69.52%）; Gram-positive bacteria were 32 strains, accounting for 30.48%. Among the Gram-negative bacteria, the top 3 species were Es- eheriehia coli（26 strains, 35.62%）, Klebsiella pneumoniae （23 strains, 31.51%） and Haemophilus influenzae（11 strains, 15.07% ）. Among the Gram-positive bacteria, staphylococcus aureus ranked the first. Gram-negative bacteria were sensitive to amikacin, imipenem and piperacillin-tazobactam. Gram-positive bacteria showed low drug resistance and were sensitive to cephalosporin an- tibiotics generally. Conclusion The pathogenic bacteria in children with lower respiratory tract infection in the local region mainly were Gram-negative bacteria with varied degrees of resistance to commonly used antibiotics. Therefore, antibiotics should be used reasonablely according to the result of drug sensitivity test in clinical practice.