儿科住院患者菌株分布和药物敏感性分析

目的 了解儿科住院患者菌株分布及药物敏感性，为临床感染性疾病诊治提供依据。方法 收集2016年1月～2017年12月四川省人民医院儿科住院患者细菌培养资料进行回顾性分析，观察菌种构成比及耐药分布。结果 共检出863株菌株，痰液标本检出细菌最多（86.6%），主要是流感嗜血杆菌、肺炎链球菌、卡他莫拉菌；其次为血液（7.1%），主要为凝固酶阴性葡萄球菌、肠杆菌科细菌。革兰阳性球菌以肺炎链球菌为主，对四环素、红霉素、复方新诺明耐药，其次为金黄色葡萄球菌，对青霉素、红霉素、克林霉素耐药；革兰阴性细菌以流感嗜血杆菌、卡他莫拉菌为主,对氨苄西林、复方新诺明耐药，其次为肠杆菌科中的肺炎克雷伯菌和大肠埃希菌，对青霉素类、三代头孢菌素类耐药。结论 儿科住院患者以流感嗜血杆菌、肺炎链球菌、卡他莫拉菌感染为主，对常用抗菌药物均有不同程度耐药，临床应根据病原菌的种类和对抗菌药物敏感性,正确合理选用抗菌药物，控制多重耐药菌的产生。

Analysis of strains distribution and drug sensitivity in pediatric inpatients

Objective To understand the distribution and drug sensitivity of strains in pediatric inpatients, and provide evidence for diagnosis and treatment of clinical infectious diseases. Methods Bacterial culture data of paediatric inpatients from January 2016 to December 2017 were retrospectively analyzed, and the proportion of bacterial species and drug sensitivity were observed. Results 863 strains of bacteria were mainly detected in samples of sputum (86.6%) and blood (7.1%). Haemophilus influenzae, Streptococcus pneumoniae and Moraxelle catarrhalis were the major baceteria in sputum. While coagulase negative Staphylococcus and Enterobacteriaceae were main strains in blood. Gram positive cocci were mainly Streptococcus pneumoniae, which was resistant to tetracycline, erythromycin and compound neonammin, followed by Staphylococcus aureus with resistance to penicillin, erythromycin and clindamycin. Gram negative bacteria were mainly Haemophilus influenzae and Moraxelle catarrhalis, which was resistant to ampicillin and SMZ TMP. And it was also included Klebsiella pneumoniae and Escherichia coli with resistance to penicillins and the third generation cephalosporins. Conclusion The major bacteria in paediatric inpatients are Haemophilus influenzae, Streptococcus pneumoniae and Moraxelle catarrhalis, which have different degree of resistance to commonly used antibiotics.Clinical should be based on the type of pathogen and sensitivity to antibiotics ,And the antibiotics should be selected correctly to control the production of multidrug resistant bacteria.