儿童支气管肺炎革兰阴性菌耐药监测分析

目的：监测儿童支气管肺炎革兰阴性菌分布及耐药情况，为临床合理用药提供依据。方法：对2009年分离于支气管肺炎患儿痰液的272株革兰阴性致病菌分布及药敏试验数据进行统计、分析。结果：分离菌株中，以肺炎克雷伯菌、大肠埃希菌为主，产超广谱β-内酰胺酶（ESBLs）菌占52.9%。除美罗培南及阿米卡星以外，产ESBLs菌株对其他抗菌药物的耐药率高于非产ESBLs的菌株，差异有统计学意义（P<0.05）。产ESBLs的革兰阴性菌株对美罗培南的耐药率最低，仅为0.7%，其次为亚胺培南、阿米卡星、头孢哌酮/舒巴坦。结论：应高度重视儿科较高的产ESBLs菌株的检出率及耐药率，根据耐药监测结果合理应用抗菌药物。

Antibiotic resistance of gram-negative Bacillis isolated from children with bronchopneumonia

Objective To study the distribution and antibiotic resistance of gram-negative pathogens isolated from children with bronchopneumonia.Methods The distribution and the results of susceptibility tests of 272 strains of gram-negative Bacillis isolated from children with bronchopneumonia during 2009 were analyzed.Results Among the isolates,the common pathogens were Klebsiella pneumoniae and Escherichia coli.The extended-spectrum β-lactamase(ESBLs) production rate was 52.9%.Compared with the non-ESBLs producing strains,ESBLs-producing strains had a significantly higher drug resistance rate to many antibiotics except amikacin and meropenem(P<0.05).The lowest resistance to ESBLs producing gram negative strains was found for meropenem(0.7%),followed by imipenem,amikacin and cefoperazone/sulbactam.Conclusions More attentions should be paid to the high rate of drug-resistance of ESBLs producing strains in children.Antimicrobial therapy should be based on the results of drug resistance surveillance.