儿童下呼吸道感染217株细菌分析及药物敏感趋势监测

目的:了解儿童下呼吸道感染致病菌的流行趋势和药物敏感性,为临床合理用药提供依据.方法:对2010年3月1日～2011年8月31日在我科住院的下呼吸道感染患儿痰液标本中分离出的病原菌进行药物敏感性监测分析.结果:共分离出217株病原菌.G-杆菌以大肠埃希菌(28.11％)、解鸟氨酸克雷伯菌(7.37％)、洛菲不动杆菌(6.91％)为主；G+菌以腐生葡萄球菌(9.68％)、表皮葡萄球菌(6.45％)、金黄色葡萄球菌(3.69％)为主.G-杆菌对第三代头孢菌素中的头孢他啶、头孢吡肟、氨曲南、亚胺培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、阿米卡星等抗生素敏感性高；G+球菌对青霉素、红霉素、克林霉素及阿奇霉素耐药率高,对其他抗生素敏感.超广谱β-内酰胺酶(ESBLs)的确证试验结果:61株大肠埃希菌产酶率55.74％；21株腐生葡萄球菌、耐甲氧西林凝固酶阴性葡萄球菌(MRSCN)产酶率9.52％,14株表皮葡萄球菌MRSCN的产酶率7.14％；5株屎肠球菌高水平氨基糖苷类耐药株( HLAR)40.00％,4株粪肠球菌HLAR为25.00％.结论:加强细菌培养和耐药性监测对临床合理使用抗生素十分必要.

Analysis of 217 Strains Bacteria and their Drug Susceptibility from Hospitalized Children with Lower Respiratory Tract Infections

Objective: To investigate the trend of lower respiratory tract infections in children and drug susceptibility to provide basis for reasonable use of drugs in clinical practice.Methods: A total of 217 strains of bacteria were isolated from sputum specimen of children who were hospitalized with lower respiratory tract infections form March 2010 to August 2011 in our hospital.The bacteria were cultured with blood dish and identified.Drug susceptibility was monitored.Results: 217 strains of bacteria were isolated.The first three places of Gram-negative bacilli were Escherichia coli(28.11%),Klebsiella omithinolytica(7.37%) and Acinetobacter lwoffi(6.91%).The first three places of Gram-positive cocci were S.saprophyticus(9.68%),S.epidermidis(6.45%) and S.aureus(3.69%).The sensitive drugs to Gram-negative bacilli were ceftazidime,cefepime,aztreonam,imipenem,piperacillin/tazobactam,cefoperazone/sulbactam and amikacin.Gram-positive cocci showed high resistance to benzylpenicillin,erythromycin,clindamycin and azithromycin,and showed sensitivity to other antibiotics.The incidence of ESBLs in 61 strains Escherichia coli was 55.74%.The incidences of MRSCN in 21 strains staphylococcus saprophyticus and 14 strains staphylococcus epidermidis were 9.52% and 7.14%,respectively.The incidences of HLAR in 5 strains Enterococcus faecium and 4 strains E.faecalis were 40.00% and 25.00%,respectively.Conclusions: It is necessary for rational use of antibiotics by enhancing bacterial culture and drug resistance monitoring.