儿童感染性肺炎痰培养病原菌分布特点及耐药性分析

目的:了解本地区儿童感染性肺炎病原菌的分布及其耐药情况,为临床治疗提供参考。方法:收集2017年3月至2018年2月在我院儿科住院的肺炎患儿病例资料进行回顾性分析。结果:517例患儿痰液细菌培养阳性213例,阳性率41.20%。共分离出致病菌239株,依次为肺炎链球菌(34.73%)、流感嗜血杆菌(33.05%)、卡他莫拉菌(19.25%)及金黄色葡萄球菌(6.69%)。肺炎链球菌对红霉素、克林霉素耐药率高(>95%),对青霉素、万古霉素、利奈唑胺敏感性高。金黄色葡萄球菌对氨苄西林、青霉素的耐药率达100%,对红霉素、克林霉素耐药率93.75%,对利奈唑胺、万古霉素、替考拉宁均敏感。流感嗜血杆菌及卡他莫拉菌对阿奇霉素均有较高的耐药性,流感嗜血杆菌对氨苄西林、头孢克洛及头孢呋辛有较高的耐药性,均>60%,对头孢噻肟、阿莫西林/克拉维酸等耐药性较低。卡他莫拉菌对红霉素耐药率达78.57%,对阿莫西林/克拉维酸高度敏感。结论:肺炎链球菌、流感嗜血杆菌是本地区儿童肺炎的主要病原菌,在不同季节检出率有所不同。治疗时应根据病原菌种类及药敏结果合理选择抗菌药物,减少耐药菌株的产生。

Distribution Characteristics and Drug-Resistance of Pathogens Isolated from Sputum Culture of Children with Infectious Pneumonia

Objective:To investigate the distribution characteristics and drug-resistance of pathogens isolated from sputum culture of children with infectious pneumonia in this region,so as to provide reference for clinical treatment.Methods:Data of children with pneumonia hospitalized in pediatrics of our hospital from Mar.2017 to Feb.2018 were collected for retrospective analysis.Results:Of the 517 children,213 cases of bacterial culture were positive in children’s sputum,with positive rate of 41.20%.Totally 239 strains of pathogens were isolated,respectively Streptococcus pneumoniae(34.73%),Haemophilus influenzae(33.05℅),Moraxella catarrhal(19.25%)and Staphylococcus aureus(6.69%).S.pneumoniae was highly resistant to erythromycin and clindamycin(>95%)and highly sensitive to penicillin,vancomycin and linezolid.The resistance rate of S.aureus to ampicillin and penicillin reached 100%,and the resistance rate to erythromycin and clindamycin reached 93.75%,and S.aureus were sensitive to linezoild,vancomycin and teicoplanin.H.influenzae and M.catarrhal were highly resistant to azithromycin.H.influenzae had high resistance to ampicillin,cefaclor and cefuroxime(>60%),and low resistance to cefotaxime,amoxicillin/clavulanic acid.The resistance rate of M.catarrhal to erythromycin was 78.57%,and M.catarrhal was highly sensitive to amoxicillin/clavulanic acid.Conclusion:S.pneumoniae and H.influenzae are main pathogens of pneumonia in children in this region,and the detection rate varies in different seasons.Antibiotics should be reasonably selected according to the type of pathogens and drug sensitivity during treatment,so as to reduce the generation of drug-resistance strains.