摘要
目的调查儿童先天性心脏病术前患儿肺部感染病原菌的分布特点及耐药现状,为临床用药提供依据。方法对2006年12月至2008年3月第三军医大学新桥医院PICU收治的338例先天性心脏病术前肺部感染患儿吸取下呼吸道痰液,进行细菌培养和药敏分析。结果检出致病菌179株,阳性率为52.95%。以肺炎链球菌菌最为多见(23.46%)。药敏显示革兰阳性球菌对青霉素类、头孢类、红霉素类耐药率较高;革兰阴性杆菌对大部分青霉素类、大部分头孢类耐药率较高。结论先天性心脏病术前患儿肺部感染病原菌以G+球菌与G-杆菌大致相等,细菌耐药日趋严重,根据体外药敏结果合理选用抗生素十分必要。对严重肺部感染,选用三代头孢治疗无效、原发病较为严重者,可首选亚胺培南抗菌治疗。
Objective To investigate pathogen distribution characteristic and the current antibiotic resistance situation in congenital heart disease ehildren complicated with pneumonia before operation to provide some bases ior clinical application. Methods Suck the lower respiratory tracts phlegm in 338 congenital heart disease children complicated with lung fever before operation in PICU,and make bacterial culture and drug sensitivity analysis. Results The research examined out 179 pathogens,with positive rate of 52. 95%. Streptococcus pneumoniae was the most common （23.46% ）. Drug sensitivity analysis showed gram positive coccus had a high resistance situation to penicillins, cephalosporins and erythrocins; gram negative bacilli had a resistance situation to most of penicillins and cephalosporins. Conclusion Positive gram posi- tive coccus is roughly tire same quantity with gram negative bacilli in congenital heart disease children complicated with pneumonia before operation. The current antibiotic resistance situation becomes more serious than ever. It is very essential to select antibiotic for use rationally according to the result of susceptibility test in vitro, lmipenem can be the preferred antibiotics for those patients with serious lung infection, especially those who already receive third-generation cephalospo- rins,or have a comparatively serious primary disease.
出处
《中国实用儿科杂志》
CSCD
北大核心
2008年第11期842-844,共3页
Chinese Journal of Practical Pediatrics
关键词
儿童
先天性心脏病
肺部感染
细菌培养
Children
Congenital heart disease
Pulmonary infection
Bacterial culture
