婴幼儿大肠埃希菌性肺炎177例临床分析

目的分析婴幼儿大肠埃希菌性肺炎患儿的临床特征及药敏情况，指导临床肺炎诊治。方法回顾性分析177例住院婴幼儿大肠埃希菌性肺炎患儿的临床表现、X线表现、细菌耐药情况及治疗预后。结果患儿的临床表现主要的症状为咳嗽、咳痰、发热，容易出现呼吸困难。 X线主要表现为片状影或间质渗出。大肠埃希菌多数菌株对泰能、美平、头孢他定、丁胺卡那霉素、左氧氟沙星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦敏感性高，对大多数β内酰胺类抗生素普遍耐药。产超广谱β内酰胺酶（ ESBLs ）菌33例，阳性率为18.6％。痰液培养细菌阳性转阴比较慢，治疗主要以经验疗法和药敏试验结果结合，病程迁延，预后尚好。结论婴幼儿大肠埃希菌肺炎是儿科常见病，临床诊治相对容易。但大肠埃希菌抗菌药物的耐药率高，需引起重视。

Clinical analysis of pneumonia infected with escherichia coli in 177 infants

Objective To analyze the clinical characteristics and antimicrobial susceptibility of pneumonia infected with Escherichia coli in infants for clinical pneumonia treatment .Methods Retrospective analysis was per-formed for 177 cases of pneumonia infected with Escherichia coli in hospitalized infants with clinical manifestations , X-ray findings , bacterial drug resistance and treatment outcome .Results The main symptoms of clinical manifesta-tions in infants of pneumonia infected with Escherichia coli were cough , sputum, fever, and likely to prone to breath-ing difficulties .X-ray mainly showed patchy or interstitial exudation .The drug sensitivity test showed that Escherichia coli were sensitive to tienam, mei-ping, ceftazidime, amikacin,levofloxacin, piperacillin/tazobacta and cefopera-zone/sulbactam.While they were resistant to most β-lactam antibiotics.There were 33 cases of pneumonia of Esche-richia coli with producing extended-spectrum β-lactamase（ESBLs） bacteria with 18.6% positive rate.The negative conversion sputum culture of Escherichia coli in pneumonia infants was relatively slow .Treatment for pneumonia in-fected with Escherichia coli in infants was mainly empirical therapy combined with drug susceptibility test results ac -cording to sputum culture of Escherichia coli , while the prognosis of pneumonia infected with Escherichia coli was still good although prolonged course .Conclusion Escherichia coli pneumonia in infants was a common pediatric disea-ses, which clinical diagnosis relatively easy .However, there be likely needed to pay attention to higher antimicrobial resistance to Escherichia coli .