儿童重症社区获得性肺部感染的病原菌分布及耐药研究

发布时间：2018-01-22 04:59

本文关键词： 肺部感染儿童患者病原菌耐药性　出处：《中华医院感染学杂志》2017年13期 　论文类型：期刊论文

【摘要】：目的探究聊城市东昌府区妇幼保健重症社区获得性肺部感染儿童主要病原菌分布情况及菌株耐药情况,为肺部感染患儿的治疗提供依据。方法选取2013年1月-2015年12月医院临床确诊为肺炎且经痰培养证实为肺部感染的422例患儿为研究对象,收集患儿痰液进行病原菌培养与检测,使用MIC或K-B纸片扩散法进行药敏试验。结果肺部感染患儿共检测痰液样本422份,共检出病原菌422株,其中革兰阴性菌245株,占58.1%,革兰阳性菌176株,占41.7%,真菌1株,占0.2%;药敏试验结果发现革兰阴性菌中肺炎克雷伯菌、大肠埃希菌和嗜血杆菌属对哌拉西林、氨苄青霉素等的耐药率达90%,对阿米卡星、左氧氟沙星、亚胺培南和美洛培南高度敏感;革兰阳性菌中金黄色葡萄球菌对氨苄青霉素、哌拉西林耐药率接近100%,对环丙沙星、庆大霉素、左氧氟沙星、万古霉素、利福平等药物高度敏感。结论儿童获得性肺部感染病原菌以革兰阴性菌为主,病原菌对哌拉西林和氨苄青霉素耐药性较强,临床治疗时应针对性应用抗菌药物,以提高患儿治疗效果。
[Abstract]:Objective to investigate the distribution of major pathogens and drug resistance in children with severe community-acquired pulmonary infection in Dongchang District of Liaocheng City. Methods 422 children with pneumonia confirmed by sputum culture from January 2013 to December 2015 were selected as the study objects. The sputum of children was collected for pathogen culture and detection, and drug sensitivity test was carried out by MIC or K-B disk diffusion method. Results 422 sputum samples were detected and 422 strains of pathogens were detected in children with pulmonary infection. There were 245 Gram-negative bacteria (58.1%), 176 Gram-positive bacteria (41.7%) and 1 fungus (0.2%). Drug sensitivity test showed that Klebsiella pneumoniae Escherichia coli and Haemophilus were resistant to piperacillin ampicillin and so on in Gram-negative bacteria. The drug resistance rates of Klebsiella pneumoniae Escherichia coli and Haemophilus were 90% to amikacin levofloxacin. Imipenem and meropenem were highly sensitive; The resistance rate of Staphylococcus aureus to ampicillin and piperacillin in Gram-positive bacteria was close to 100, and to ciprofloxacin, gentamicin, levofloxacin, vancomycin. Conclusion Gram-negative bacteria are the main pathogens of children's acquired pulmonary infection, and the pathogens have strong resistance to piperacillin and ampicillin. In order to improve the therapeutic effect of children.
【作者单位】：聊城市东昌府区妇幼保健院儿科;聊城市东昌府区妇幼保健院新生儿科;
【基金】：山东省医药卫生科技发展计划基金资助项目(2016WSA15088)
【分类号】：R446.5;R725.6
【正文快照】： 近年来,随环境的变化以及病原菌的广泛传播,儿童社区获得性肺部感染发生率逐年提升,已经成为影响儿童身体健康的重要疾病[1]。由于儿童身体机能发育尚不完善,加之抵抗能力较弱,因此很容易发生肺部感染,但由于肺部感染患儿早期症状不明显,病情进展较快,往往不易引起患儿及监护

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