急性肺损伤(呼吸窘迫综合征)患儿细菌检出情况分析

目的探究急性肺损伤(呼吸窘迫综合征)患儿病原菌分布状况及药敏检测结果,以指导临床合理用药。方法回顾性分析2017年5月至2019年5月在武汉市妇幼保健院诊断为急性肺损伤(呼吸窘迫综合征)的患儿共254例,所有患儿均采集痰标本,进行病原微生物检测,并进行药敏实验分析。结果254例患儿中共分离出病原菌127株。革兰阴性杆菌为主要感染病原菌,其中鲍曼不动杆菌感染者有38株,占29.92%,大肠埃希菌感染者有13株,占10.23%;肺炎克雷伯菌感染者有10例株,7.87%,真菌感染42株,占33.07%。混合感染者患儿有26例,其中16例为鲍曼不动杆菌和白假丝酵母菌感染,占所有混合感染患者的61.54%。鲍曼不动杆菌对多种抗菌药物耐药,对亚胺培南敏感性>50.00%。结论革兰阴性杆菌为急性肺损伤(呼吸窘迫综合征)患儿的主要致病菌,鉴于感染率最高的鲍曼不动杆菌对多种药物耐药,应动态检测病原菌的耐药性,合理选择抗菌药物进行治疗。

Analysis of bacterial detection in children with acute lung injury(respiratory distress syndrome)

Objective To investigate the distribution of pathogenic bacteria and the results of drug sensitivity test in children with acute lung injury(respiratory distress syndrome),so as to guide rational clinical drug use.Methods A total of 254 cases of children diagnosed with acute lung injury(respiratory distress syndrome)in Wuhan Children's Hospital from May 2017 to May 2019 were retrospectively analyzed.Sputum samples were collected from all children for pathogenic microorganisms detection and drug sensitivity test.Results Of 127 strains of pathogenic bacteria were isolated from 254 children.Gram-negative bacilli were the main pathogenic bacteria,among which 38 strains of acinetobacter baumannii were infected,accounting for 29.92%,and 13 strains of pseudomonas aeruginosa were infected,accounting for 10.23%.There were 10 strains of stenotrophomonas maltophilia(7.87%)and 42 strains of fungal infection(33.07%).There were 26 cases of mixed infection,of which 16 cases were infected with acinetobacter baumannii and candida albicans,accounting for 61.54%.Acinetobacter baumannii was resistant to a variety of antibacterial drugs and had a sensitivity of>50%to imipenem.Conclusion Gram-negative bacilli were the main pathogenic bacteria in children with acute lung injury(respiratory distress syndrome).Given that acinetobacter baumannii with the highest infection rate is resistant to various drugs,it is necessary to dynamically detect the resistance of pathogenic bacteria and reasonably choose antimicrobial agents for treatment.