重症肺炎患儿病原学调查及病原菌耐药性分析

发布时间：2018-07-13 12:24

【摘要】：目的了解南京市儿童医院重症肺炎患儿病原学分布及主要病原菌耐药性。方法选取2016年01月-12月重症肺炎患儿198例作为研究对象,收集患儿鼻咽分泌物行病原菌培养及药敏鉴定,并采用实时荧光定量PCR技术(qPCR)对其他病原进行检测。结果 198例患儿中有141例检出至少一种病原体,总检出阳性率为71.2%;共检出病原菌115株,占46.37%,其中革兰阴性菌85株,占34.27%,革兰阳性菌31株,占12.50%,病原菌中鲍氏不动杆菌检出最多,为21株占8.47%;共检出病毒86株,占34.68%,鼻病毒检出最多,为21株占8.47%;非典型病原体46株占18.55%,肺炎支原体31株占12.5%,为检出最多的病原体;药物敏感试验提示革兰阴性菌对常见的青霉素类及一、二代头孢均有很高的耐药率,对于三、四代头孢菌素以及碳青霉烯类等药物也有一定程度的耐药。结论南京地区儿童重症肺炎病原仍以病原菌为主,革兰阴性菌占优势,主要病原菌对多种抗菌药物耐药。
[Abstract]:Objective to investigate the pathogenic distribution and drug resistance of major pathogens in children with severe pneumonia in Nanjing Children's Hospital. Methods 198 children with severe pneumonia from January to December 2016 were selected to collect nasopharyngeal secretions for pathogen culture and drug sensitivity identification, and real-time fluorescence quantitative PCR (qPCR) was used to detect other pathogens. Results at least one pathogen was detected in 141 out of 198 cases, the total positive rate was 71.2%, 115 strains (46.37%) were detected, of which 85 strains were Gram-negative bacteria (34.27%), 31 strains were Gram-positive bacteria (12.50%), and the most were Acinetobacter baumannii. There were 86 strains of virus (34.68%), 21 strains of rhinovirus (8.47%), 46 strains of atypical pathogens (18.55%) and 31 strains of mycoplasma pneumoniae (12.5%). The drug sensitivity test indicated that Gram-negative bacteria had high resistance to penicillin and the first and second generation cephalosporins, and to some extent to the third and fourth generation cephalosporins and carbapenes. Conclusion the main pathogens of severe pneumonia in children in Nanjing are mainly pathogenic bacteria, Gram-negative bacteria are dominant, and the main pathogens are resistant to many kinds of antimicrobial agents.
【作者单位】：扬州大学附属医院儿科;南京医科大学附属儿童医院呼吸科;
【分类号】：R725.6

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