儿科住院患者痰液病原菌类型及其耐药性分析

目的：了解医院儿科住院患者痰液病原菌类型及耐药性情况。方法：分离儿科病房送检痰液标本病原菌，采用Vitek2-Compact系统鉴定细菌，K-B纸片扩散法进行药物敏感试验，分析常见病原菌耐药性。结果：2010-2012年共送检标本2814份，检出病原菌1005株，检出率35．71％。其中革兰阳性菌335株，以金黄色葡萄球菌、表皮葡萄球菌、肺炎链球菌为主。革兰阴性茵625株，以流感嗜血杆菌、肺炎克雷伯茵、副流感嗜血杆菌、大肠埃希茵和卡他莫拉菌常见。真菌45株，以白色假丝酵母茵和热带假丝酵母茵常见。葡萄球茵对青霉素和红霉素耐药性较高，肺炎链球茵对红霉素和复：方磺胺甲嗯唑高度耐药。大肠埃希茵和肺炎克雷伯茵对头孢菌素类的耐药率约60％，嗜血杆菌对氨苄西林、阿奇霉素、复方磺胺甲嗯唑存在不同程度的耐药。卡他莫拉茵对青霉素和氨苄西林高度耐药。结论：儿童下呼吸道感染以革兰阴性菌为主，临床上应及时检测，应根据本院病原菌谱及药敏情况合理选择抗茵药．

Pathogen Distribution and Drug Resistance Analysis on Sputum of Pediatric Inpatients

Objective ：To analyze the distribution and changes in drug resistance of pathogens causing respiratory tract infections in pediatrics department to provide the evidence for clinical treatment. Methods：Pathogens in sputum were isolated, strains were identified with Vitek2-Compact system, the drug sensitivity was performed with the disc diffusion method（ K-B law）, and the drug resistance of pathogens was analyzed. Results： 1 005 strains of pathogens were isolated from 2 814 sputum samples from 2010 to 2012. Three hundred and thirty-five of the stains were gram-positive bacteria. The most strains isolated was staphylococcus aureus, followed by staphylococcus epidermidis and streptococcus pneumoniae; 625 stains were gram-negative bacteria. The most strains isolated was haernophilus influenzae, followed by klebsiella pneumoni-ae, haemophilus parainfluenzae, escherichlia coli and moraxeUe catarrhalis. 45 stains were fungus, and the most strains iso-lated was Candida albicans, followed by Candida tropicalis. Staphylococcus had its high resistance to benzvloenicillin and e-rythromycin, and streptococcus pneumoniae had its high resistance to erythromycin and trimethoprim-sulfamethoxazole. The resistance rate of klebsiella pneumoniae and escherichia coli cephalosporins was almost 60%. Haemophilus was resistant to ampicillin, azithromycin and trimethoprim-sulfamethoxazole in different degree. Moraxelle catarrhalis had its high resistance to benzylpenicillin and ampicillin. Conclusion：The bacteria isolated from the Pediatrics Department were mainly gram-neg-ative bacteria, different bacteria had their different resistance to antibiotics, the sputum sample should be tested in time and clinicians should choose correct antibiotics according to the pathogens distribution and drug resistance test.