摘要
目的分析某基层医院儿童社区获得性肺炎(CAP)病原菌分布及其耐药性,以指导临床合理使用抗菌药物。方法选取2010年1月—2013年11月在苍溪县人民医院诊治的CAP患儿752例,在使用抗菌药物之前收集痰液进行培养,并鉴定菌株及进行药敏试验。结果 752例患儿采集到合格标本674例,合格率为89.62%;细菌检出率为34.87%(235/674);其中革兰阳性菌89株(占37.87%),革兰阴性菌146株(占62.13%)。不同年龄段患儿主要致病菌排序有所不同,≤3岁患儿主要致病菌为革兰阴性菌,占64.77%;>3岁患儿主要致病菌为肺炎链球菌,占42.86%。肺炎链球菌对氟喹诺酮类抗菌药物耐药率较低,均在16.0%以下;金黄色葡萄球菌对氟喹诺酮类抗菌药物耐药率较低,均在18.0%以下;溶血葡萄球菌对头孢呋辛和庆大霉素的耐药率较低,均为12.5%;大肠埃希菌对莫西沙星的耐药率较低,为14.3%;流感嗜血杆菌对氟喹诺酮类抗菌药物的耐药率较低,均在20.0%以下;肺炎克雷伯菌对头孢硫脒和头孢唑肟的耐药率较低,均为17.2%;卡他莫拉菌对左氧氟沙星和莫西沙星的耐药率较低,均为7.1%。结论苍溪县人民医院儿童CAP的主要致病菌为革兰阴性菌,且病原菌分布与年龄有一定关系,根据病原菌耐药情况给予经验性抗菌药物治疗对改善CAP患儿的预后具有重要意义。
Objective To analyze the pathogenic bacteria distribution and drug resistance of children with community -acquired pneumonia in the People＇s Hospital of Cangxi County, to guide the clinical rational use of autimicrobial agents. Methods A total of 752 children with community - acquired pneumonia were selected in the People＇s Hospital of Cangxi County from January 2010 to November 2013, and their sputum were collected before using antimicrobial agents to cultivate the pathogenic bacteria and carry out drug sensitive test. Results The percent of pass of sputum samples was 89. 62% （ 674/752 ） , the detection rate of bacteria was 34. 87% （235/674）. Of the 235 strains of pathogenic bacteria, 89 strains were Gram - positive bacteria （accounting for 37. 87% ） , 146 strains were Gram - negative bacteria （accounting for 62. 13% ）. In children equal or less than 3 years old, the major pathogenic bacteria was Gram - negative bacteria （ accounting for 64. 77% ） ; in children over 3 years old, the major pathogenic bacteria was Streptococcus pneumoniae （accounting for 42.86% ）. The drug resistant rates to fluoroquinolone antimicrobials of Streptococcus pneumoniae were less than 16.0% ; the drug resistant rates to fluoroquinolone antimicrobials of Staphylococcus aureus were less than 18. 0%; the drug resistant rates to cefuroxime and gentamicin of Staphylococcus haemolyticus were both 12. 5% ; the drug resistant rates to moxifloxaein of Escherichia coli was 14. 3% ; the drug resistant rates to fluoroquinolone antimicrobials of Haemophilus influenzae were less than 20. 0% ; the drug resistant rates to cefathiamidine and ceftizoxime of Klebsiella pneumoniae were both 17.2%; the drug resistant rates to levofloxacin and moxifloxacin of Moraxella catarrhalis were both 7. 1%. Conclusion Gram - negative bacteria is the major pathogenic bacteria of children with community- acquired pneumonia in the People＇s Hospital of Cangxi County, and the distribution is related with age ; empiric antimicrobial therapy based on drug resistance is helpful to improve the prognosis of children with community -acquired pneumonia.
出处
《实用心脑肺血管病杂志》
2015年第12期39-42,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
社区获得性肺炎
儿童
病原菌
耐药
Community acquired pneumonia
Child
Pathogenic bacteria
Drug resistance
