摘要
目的:了解诸暨地区小儿下呼吸道感染的病原学特点及其对抗菌药物的耐药性,为儿科合理使用抗生素提供参考和指导。方法:采用回顾性分析方法对诸暨市妇幼保健院2008年1月-2009年8月儿科送检的合格痰液培养鉴定及药物敏感试验结果进行统计、分析。结果:2 018例痰液标本分离到病原菌1 146株,总阳性率为56.8%,其中革兰阳性菌218株,占19.02%(218/1146),革兰阴性菌718株,占62.65%(718/1146),真菌195例,占17.01%(195/1146)。感染前4位的革兰阴性菌分别是大肠埃希菌、肺炎克雷柏菌、铜绿假单胞菌、鲍曼不动杆菌,革兰阳性菌主要以金黄色葡萄菌为主,占77.06%(168/218),真菌以白色念珠菌为主,占71.28%(139/195)。药物敏感试验结果显示,大肠埃希菌、肺炎克雷伯菌产ESBLS(超广谱B-内酰胺酶实验)率分别是50.96%、50.00%,二菌株对亚胺培南、美洛培南、呋喃妥因的敏感率为100%。金黄色葡萄球菌耐青霉素率为95.60%,未发现耐万古霉素的金黄色葡萄球菌。结论:该地区小儿下呼吸道感染的病原菌以革兰阴性菌为主,大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为最常见的病原菌。真菌(白色念珠菌为主)的检出率较高,以及耐菌药物的日益增多,提示儿科亟需根据药物敏感试验结果合理选用抗菌药物,缩短用药周期,避免乱用、滥用抗菌药物,从而提高诊疗效果。
Objective To explore pathogenetic characters and resistance to antimicrobial drugs of the lower respiratory tract infection in children in Zhuji so as to provide reference and guidance for rational use of antibiotics.Methods A restrospective analysis was made of qualified pediatric sputurm culture identification and drug sensitivity test results from January 2008 to August 2009.Results 1,146 pathogens were isolated form 2,018 sputum samples,the total positive rate being 56.8%,of which 218 were Gram-positive bacteria,718 Gram-negative bacteria,195 fungi,accounting for 19.02%(218/1146),62.65%(718/1146) and 17.01%(195/1146),respectively.The first four Gram-negative bacteria were Escherichia coli,pneumonia Ke Leibo bacteria,Pseudomonas aeruginosa,and Acinetobacter baumannii.Gram-negative bacteria were mainly Staphylococcus aureus bacteria,accounting for 77.06%(168/218).Fungi were mainly Candida albicans,accounting for 71.28%(139/195).Drug sensitivity test results showed that Escherichia coli,Klebsiella pneumoniae producing ESBLS rates were 50.96%,and 50.00%,respectively.Their sensitivity rate to imipenem,meropenem,and nitrofurantoin was 100%.Penicillin-resistant rate of Staphylococcus aureus was 95.60% and no vancomycin-resistant Staphylococcus aureus was found.Conclusion Gram-negative bacteria are the main pathogens of lower respiratory tract infection of children,of which Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa are the most common ones.A higher detection rate of Fungi(mainly Candida albicans) as well as the growing number of drug-resistant bacteria suggest that selection of antimicrobial drugs in pediatrics should be based on drug senstivity test results which can reduce the medication cycle,avoid the abuse of antimicrobial drugs,so as to enhance clinical results.
出处
《中国农村卫生事业管理》
2010年第6期481-483,共3页
Chinese Rural Health Service Administration
关键词
小儿
下呼吸道感染
病原菌
耐药性
children
lower respiratory tract infection
pathogen
resistance
