小儿感染性肺炎痰培养病原菌分布特点与耐药分析

目的 总结分析小儿感染性肺炎的病原菌分布及耐药情况,明确松岗地区小儿感染性肺炎病原菌特点.方法 选择2015年7月至2016年6月期间我院儿内科诊治的1094例疑似感染性肺炎患儿为研究对象,对患儿的痰液标本进行细菌学培养及药敏试验.结果 本组1094例患儿共培养出372株病原菌,阳性率为32.2%.其中革兰氏阴性杆菌以流感嗜血杆菌(47.3%)和肺炎克雷伯菌肺炎亚种(6.7%)为主,革兰氏阳性球菌以肺炎链球菌(24.5%)和金黄色葡萄球菌为主(8.9%);流感嗜血杆菌与肺炎克雷伯菌肺炎亚种对氨苄西林、头孢噻肟耐药率分别为54%、0及100%(天然耐药)、32%.肺炎链球菌与金黄色葡萄球菌对万古霉素均较敏感.结论 松岗地区小儿感染性肺炎病原菌以流感嗜血杆菌及肺炎链球菌为主,其次为肺炎克雷伯菌肺炎亚种及金黄色葡萄球菌.临床上应根据药敏结果指导抗菌药物的合理应用,避免耐药性的增加,提高临床疗效.

Distribution and drug resistance of pathogenic bacteria in sputum culture of children with infectious pneumonia

Objective To summarize and analyze the distribution and drug resistance of pathogenic bacteria in children with infectious pneumonia, and to define the characteristics of infectious pneumonia in children in Songgang, Baoan District, Shenzhen. Methods From July 2015 to June 2016, 1094 children with pneumonia treated in Depart-ment of Pediatric Internal Medicine in our hospital were selected as the research objects. The sputum was detected by bacterial culture and drug sensitivity test. Results In the 1094 children, a total of 372 strains of pathogenic bacteria were cultured, and the positive rate was 32.2%, with Hemophilus influnzae (47.3%) and Klebsiella pneumoniae (6.7%) dominated the Gram-negative bacteria, and Streptococcus pneumoniae (24.5%) and Staphylococcus aureus (8.9%) dominat-ed the Gram-positive bacteria. The resistance rates of Hemophilus influnzae and Klebsiella pneumoniae to ampicillin, ce-fotaxime were 54%, 0 and 100% (natural resistance), 32%, respectively. Streptococcus pneumonia and Staphylococcus aureus were sensitive to vancomycin. Conclusion The main pathogens in children with infectious pneumonia in Song-gang, Baoan District, Shenzhen were Hemophilus influnzae and Streptococcus pneumonia, followed by Klebsiella pneumo-nia and Staphylococcus aureus. The drug sensitivity results should be used to guide the rational use of antibiotics in clini-cal practice, and to avoid the increase of drug resistance, in order to improve the clinical efficacy.