摘要
目的研究儿童下呼吸道感染病原菌分布特点及耐药性,为临床用药提供依据,指导临床合理使用抗菌药物。方法回顾性分析医院2008年1月-2012年12月3 684例下呼吸道感染住院患儿的痰培养及药敏试验结果,采用VITEK-2全自动微生物鉴定仪及药敏卡进行细菌鉴定及药敏试验,采用WHONET5.4微生物实验室数据处理软件对研究数据进行统计分析。结果 3 684例下呼吸道感染患儿痰培养阳性943例,阳性率为25.6%,检出革兰阴性杆菌596株占63.2%,以铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌、副流感嗜血菌多见,分别占17.9%、13.3%、9.3%、8.1%;革兰阳性球菌347株占36.8%,以肺炎链球菌、表皮葡萄球菌、金黄色葡萄球菌多见,分别占12.6%、8.2%、7.1%;主要革兰阴性杆菌对头孢呋辛、氨苄西林、磺胺甲噁唑/甲氧苄啶耐药现象较为严重,对亚胺培南、美罗培南较为敏感;革兰阳性球菌对青霉素G、苯唑西林耐药比较严重,对利奈唑胺、万古霉素则比较敏感。结论根据药敏试验选择敏感抗菌药物联合用药,对下呼吸道感染治疗效果及临床耐药菌株的减少有重要的临床意义。
OBJECTIVE To observe the characteristics of distribution of pathogens causing lower respiratory tract infections in children and analyze the drug resistance so as to provide guidance for reasonable clinical use of antibiotics. METHODS Totally 3684 children with lower respiratory tract infections who were hospitalized from Jan 2008 to Dec 2012 were recruited in the study, then the results of sputum culture and drug susceptibility testing were retrospectively analyzed, the bacterial identification was conducted with the use of VITEK-2 automatic microorganism identification system, the drug susceptibility testing was performed by using the drug susceptibility card, and the obtained data were statistically analyzed by means of the WHO-NET5. 4 microbiological laboratory data processing software. RESULTS Of the 3684 children with lower respiratory tract infections, 943 cases were with sputum cultured positive with the positive rate of 25.6%. A total of 596 （63.2%） strains of gram-negative bacilli have been isolated, among which Pseudomonas aeruginosa （17. 9 %）, Klebsiella pneumoniae （13. 3 %） , Acinetobacter baumannii （9. 3 %）, and Haemophilus parainJluenzae （8. 1 %） were the predominant species; totally 347 （36.8%） strains of gram-positive cocci have been isolated, among which the Staphylococcus aureus （12. 6 %）, Staphylococcus epidermidis （8. 2 %）, and Streptococcus pneumoniae （7. 1 %） were dominant. The main gram-negative bacilli were highly resistant to cefoxitin, ampicillin, and sulfamethoxazole-trimethoprim and susceptible to imipenem and meropenern , the gram-positive cocci were highly resistant to penicillin G and oxacillin and susceptible to vancomycin and teicoplanin. CONCLUSION It is of great clinical significance in the therapeutic effect of lower respiratory tract infections and reduction of drug resistant strains to choose susceptible antibiotics based on the result of drug susceptibility testing.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第5期1260-1262,共3页
Chinese Journal of Nosocomiology
基金
天津市卫生局科技基金项目(09KZ32)
关键词
下呼吸道感染
痰培养
药敏试验
病原菌
耐药性
Lower respiratory tract infection
Sputum culture
Drug susceptibility testing
Pathogen
Drug resistance
