住院患儿呼吸道感染常见病原菌及耐药性分析

发布时间：2018-10-11 17:59

【摘要】：目的分析住院患儿呼吸道感染常见病原菌及耐药性情况,为临床合理使用抗菌药物提供参考依据。方法选择2015年于医院住院治疗的呼吸道感染患儿890例,采用微生物半自动鉴定系统进行细菌分离及鉴定,采用K-B纸片扩散法进行药物敏感性试验,分析患儿呼吸道感染病原菌的分布情况及药敏试验结果。结果共分离出1 120株病原菌,以革兰阴性菌为主,共678株占60.5%;革兰阴性菌对青霉素类,喹诺酮类,第三代以下头孢菌素,四环素类,部分氨基糖甙类等抗菌药物耐药性较高,均90.0%,而对青霉素类+酶抑制剂、头孢菌素类+酶抑制剂、碳青酶烯类、阿米卡星等仍然较敏感;革兰阳性菌对青霉素类、克林霉素等普遍耐药,但对部分头孢菌素类、万古霉素、替考拉宁、利福平、部分喹诺酮类等仍然较敏感。结论住院患儿呼吸道感染常见病原菌中仍然以革兰阴性菌为主,临床医师可结合科室情况选择敏感抗菌药物进行经验性用药治疗。
[Abstract]:Objective to analyze the common pathogens and drug resistance of respiratory tract infection in hospitalized children, and to provide reference for rational use of antimicrobial agents in clinic. Methods A total of 890 children with respiratory tract infection who were hospitalized in hospital in 2015 were selected for bacterial isolation and identification by semi-automatic microbiological identification system, and K-B disk diffusion test was used for drug sensitivity test. The distribution of pathogenic bacteria in children with respiratory tract infection and the results of drug sensitivity test were analyzed. Results A total of 1 120 strains of pathogenic bacteria were isolated, mainly Gram-negative bacteria, 678 strains accounted for 60.5%, Gram-negative bacteria had high resistance to penicillin, quinolones, cephalosporins, tetracyclines and some aminoglycosides, etc. All of them were sensitive to penicillin inhibitors, cephalosporinase inhibitors, carbapenes, amikacin, etc. Gram-positive bacteria were generally resistant to penicillin and clindamycin, but were resistant to some cephalosporins. Vancomycin, teicoplanin, rifampicin, and some quinolones are still sensitive. Conclusion Gram-negative bacteria are still the main pathogens of respiratory tract infection in hospitalized children. The clinicians can select sensitive antibiotics to treat them empirically.
【作者单位】：宁波市北仑区第二人民医院儿科;宁波市北仑区人民医院儿科;宁波市北仑区第二人民医院检验科;
【基金】：吴阶平医学基金资助项目(201422201)
【分类号】：R446.5;R725.6

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