儿童社区获得性肺炎病原学分布及其与抗生素使用的相关性

发布时间：2018-08-21 14:04

【摘要】：目的了解中山市儿童社区获得性肺炎病原学特点及其与年龄、抗生素使用的相关性,为疾病诊断和抗生素合理使用提供参考依据。方法对中山市妇幼保健院儿科住院部2016年1月—2016年4月收治的小儿社区获得性肺炎临床资料、入院前使用抗生素和病原学检测结果进行回顾性分析。结果共有155例研究对象纳入研究,细菌检出95株,其中革兰氏阴性菌61株,革兰氏阳性菌34株。流感嗜血杆菌,金黄色葡萄球菌,肺炎链球菌,大肠埃希氏菌,副流感嗜血杆菌的占构成比前五位。支原体和衣原体现症感染率约7.7%~8.4%。RSV检出率达25.8%。年龄在3 a以上、入院前使用过抗生素者,革兰阳性菌检出率较低(P0.05)。入院前使用过抗生素者,革兰阴性菌检出率较高,且使用4 d及以上者高于使用3 d及以下者(P0.05)。结论住院儿童CAP的治疗,应综合考虑病人的年龄、入院前的抗生素使用情况,结合当地CAP的可能优势病原选择合适的治疗方案。
[Abstract]:Objective to investigate the etiological characteristics of community-acquired pneumonia in children in Zhongshan City and its correlation with age and antibiotic use, so as to provide reference for disease diagnosis and rational use of antibiotics. Methods the clinical data of pediatric community-acquired pneumonia treated in Department of Pediatrics of Zhongshan Maternal and Child Health Hospital from January 2016 to April 2016 were retrospectively analyzed. The results of antibiotic use and etiological examination before admission were analyzed retrospectively. Results A total of 155 subjects were included in the study. 95 strains of bacteria were detected, including 61 Gram-negative bacteria and 34 Gram-positive bacteria. Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Haemophilus parainfluenzae accounted for the top five. The infection rate of mycoplasma and chlamydia was 25. 8%. The detection rate of Gram-positive bacteria was lower in those who had used antibiotics before admission for more than 3 years (P0.05). The positive rate of Gram-negative bacteria was higher in those who had used antibiotics before admission, and the rate of Gram-negative bacteria after 4 days or more was higher than that of those who had used antibiotics for 3 days or less (P0.05). Conclusion in the treatment of CAP in hospitalized children, we should consider the age of the patients, the use of antibiotics before admission, and select the appropriate treatment plan combined with the possible dominant pathogens of local CAP.
【作者单位】：中山市博爱医院;
【基金】：广东省医学科研基金项目(A2009775)
【分类号】：R446.5;R725.6

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