儿童支气管肺炎常见致病菌及耐药性临床分析

目的对该院儿童支气管肺炎常见致病菌分布和耐药性情况变化进行分析,为抗菌策略的制定提供参考。方法选择2014年1~12月在该院住院的支气管肺炎患儿857例作为研究对象,进行细菌培养和药敏试验,对其结果进行分析。结果857例患儿中细菌培养结果阳性316例,阳性率为36.87%。其中革兰阳性菌175例(20.42%),革兰阴性菌130例(15.17%);肺炎链球菌140例(16.34%),流感嗜血杆菌70例(8.17%)。肺炎链球菌对青霉素加酶抑制剂、左氧氟沙星、万古霉素敏感率最高(90.00%以上),其次为第三代头孢菌素(非脑膜炎者),敏感率为80.00%以上;流感嗜血杆菌对第三代头孢菌素、氨苄西林/舒巴坦及左氧氟沙敏感率最高,均为90.00%以上,但对复方磺胺甲噁唑耐药,耐药率为80.00%。结论革兰阳性菌为导致支气管肺炎最主要的病原菌,以肺炎链球菌最为常见。在临床治疗上要重视药敏试验结果,从而调整抗菌治疗方案,达到理想疗效。

Clinical analysis of common bronchiectasis pathogenic bacteria and their drug resistance for children

Objective To analyze the distribution of common pathogenic bacteria and their drug resistance ,in children with bron‐chial pneumonia ,and provide reference for making antimicrobial treatment strategies .Methods 857 hospitalized pediatric patients with bronchopneumonia from January to December 2014 were enrolled in the study ,bacterial culture and drug susceptibility test were performed ,and the results were analyzed .Results In the 857 pdiatric patients ,the positive rate was 36 .87% (316/857) .A‐mong them ,175 cases were gram positive bacteria(20 .42% ) ,141 cases were gram negative bacteria(16 .45% ) ,140 cases were Streptococcus pneumoniae(16 .34% ) ,70 cases were Haemophilus influenzae(8 .17% ) .The susceptibility of Streptococcus pneu‐moniae to penicillin with enzyme inhibitors ,levofloxacin and vancomycin was the highest(higher than 90 .00% ) ,followed by the third generation cephalosporin(non meningitis) ,to which the sensitivity rate were above 80 .00% .The susceptibility of Haemophi‐lus influenzae to the third generation cephalosporins ,ampicillin/Sulbactam ,levofloxacin and imipenem were the highest(more than 90 .00% ) ,while the resistance to ampicillin and cotrimoxazole was 80 .00% .Conclusion Gram positive bacteria are the most im‐portant pathogenic bacteria ,and Streptococcus pneumoniae is the most common bacteria in bronchopneumonia .In clinical treatment , the results of drug sensitivity test should be paid attention to ,so as to adjust the treatment plan and achieve the ideal effect .