小儿心脏术后下呼吸道感染革兰氏阴性菌分布及常见菌耐药性分析

[目的]了解小儿心脏术后下呼吸道感染革兰阴性杆菌分布情况及耐药性，为临床合理用药提供依据。[方法]对我院2001年1月～2004年12月小儿术后恢复室下呼吸道分离革兰阴性杆菌分类，同时用微量肉汤稀释法对主要病原菌的药敏结果进行分析。[结果]小儿术后恢复室下呼吸道分离阴性杆菌主要为肺炎克雷伯菌及大肠埃希菌，嗜麦芽窄食单胞菌。铜绿假单胞菌及鲍曼不动杆菌。其中肠杆菌产ESBL比率较高且对抗生素耐药性强，亚胺培南仍是治疗产酶的肺炎克雷伯菌及大肠埃希菌最有效的抗生素。非发酵菌中嗜麦芽窄食单胞菌呈现对抗生素多重耐药，鲍曼不动杆菌及铜绿假单胞菌均出现亚胺培南耐药株。[结论]根据药敏结果合理使用抗生素对预防耐药菌株的出现有极其重要的意义。

Drug resistance and distribution of gram - negative bacilli in children with lower respiratory infection after cardiac surgery

[Objective] To investigate the drug resistance and distribution ot gram - negative bacilli in children with lower respiratory infection after cardiac surgery to provide basis for reasonable use of antibiotics in clinical practice. [Methods] The antibiotics susceptibility of gram - negative bacilli isolated from children with lower respiratory infection after cardiac surgery in our hospital from January 2001 to December 2004 was determined by MIC method. [Results] The gram- negative bacilli mainly included Klebsiella pneumoniae. Escherichia coli, Xanthomonas mahophilia, Pseudomonsa aeruginosa and Acinetobacter baumannii. The rate of ESBL - producing enterobacter was very high and it had high resistant rate to antibiotics. Imipenem was the most effective drug for it, Xanthomonas maltophilia was multi - drugresistant, Imipenem - resistant Pseudomonsa aeruginosa and Acinetobacter baumannii were also isolated, [Conclusion] Reasonable use of antibiotics based on drug - sensitive test is very important for prevention of occurrence of drug - resistant bacterial strains.