小儿呼吸道感染痰液培养细菌构成及药敏分析

目的 了解某院儿科呼吸道感染的患儿痰液培养细菌构成及药敏的耐药情况.方法 对2011年1月到2012年5月儿科呼吸道感染的1 451例患儿进行深部吸痰并进行细菌培养,对培养出的致病菌株进行药敏实验.结果 从1 451份痰标本中分离出273株致病菌,阳性率为18.8%,其中革兰阳性菌52株（19.0%）,革兰阴性菌198株（72.5%）,其他26株（9.5%）,培养分离的细菌排前列是大肠埃希氏菌58株（21.2%）、流感嗜血杆菌51株（18.7%）、金黄色葡萄球菌42株（15.4%）、肺炎克雷伯氏菌34株（12.5%）、阴沟肠杆菌16株（5.9%）、产酸克雷伯菌14株（5.1%）、铜绿假单胞菌9株（3.3%）、肺炎链球菌7株（2.6%）.体外药敏试验表明阴性杆菌对亚胺培南、阿米卡星,哌拉西林/他唑巴坦较为敏感,阳性球菌对万古霉素、利福平、复方新诺明较为敏感.结论 了解小儿呼吸道感染的细菌分布及细菌的耐药状况,可以指导临床合理运用抗生素,减少细菌耐药菌株的增多.

Analysis of bacterial constitution cultured from sputum in children with respiratory tract infection and its drug sensitivity

Objective To explore the bacterial constitute cultured from sputum in children with respiratory tract infection （RTI） and drug resistance of drug sensitivity in a hospital. Methods A total of I 451 patients with RTI in pediatric department from January 2011 to May 2012 were with sputum suction in depth,and the bacterial culture was conducted. The drug sensitive test was employed on the cultured pathogenic strains. Results 273 strains of pathogenic bacterium were isolated from 1451 sputum specimens with the positive rate of 18.8% ,52 strains of which were gram positive bacterium accounting for 19.0% and 198 strains of which were gram-negative bacterium accounting for 72.5%. The top lists of cultured isolated bacterium were 58 strains of Escherichia coli （21.2%）, 51 strains of Haemophilus influenzae （ 18.7% ）,42 strains of staphylococcus aureus （ 15.4% ）, 34 strains of Klebsiella pneumoniae （ 12.5 % ）, 16 strains of enterobacter cloacae （5.9%）, 14 strains of Klebsiella oxytoca （5.1% ）, 9 strains of pseudomonas aeruginosa（3.3% ） and 7 strains of streptococcus pneumoniae （2.6%）. Drug sensitivity test in vitro showed that gramnegative bacterium was relatively sensitive to imipenem, amikacin and piperacillin/tazobactam, while gram positive bacterium was relatively sensitive to vancomycin ,rifampicin and cotrimoxazole. Conclusion Mastery of bacterial constitution in children with RTI and its drug sensitivity can guide reasonable use of antibiotics in clinic and decrease the bacterial strains of drug resistance.