2013-2015年儿童下呼吸道感染分离菌类型及耐药性变迁

发布时间：2019-03-06 07:48

【摘要】：目的了解2013-2015年儿童下呼吸道感染常见致病菌类型及耐药性变迁情况,为患者临床治疗提供科学指导。方法收集儿童呼吸道感染患者痰液样本进行病原菌培养和菌株鉴定,采用纸片扩散法(K-B法)进行药敏试验,分析病原菌耐药性变迁情况。结果 1 743份下呼吸道感染患者痰液标本中共分离出756株病原菌,其中肺炎链球菌275株,占36.38%;流感嗜血杆菌181株,占23.94%;卡他莫拉菌211株,占27.91%;其他菌89株,占11.77%。肺炎链球菌对青霉素耐药率为100.00%,对阿莫西林、复方新诺明、氯霉素、红霉素、克林霉素、头孢噻肟等的耐药率分别为72.36%、35.27%、26.55%、85.09%、74.55%和0.73%,未检出对头孢曲松和左氧氟沙星耐药菌株。流感嗜血杆菌对氨苄西林、利福平、氯霉素、四环素、头孢噻肟和头孢曲松的耐药率分别为59.67%、2.76%、22.10%、33.15%、0.55%和0.55%,对利福平、头孢曲松和头孢噻肟较敏感;流感嗜血杆菌对氨苄西林耐药率较高,对利福平、头孢曲松和头孢噻肟较敏感。卡他莫拉菌对青霉素、阿莫西林、氨苄西林、利福平、苯唑西林、呋喃妥因、头孢噻肟和头孢曲松耐药率分别为100.00%、76.67%、73.46%、29.38%、35.07%、24.17%、1.42%和0.95%;卡他莫拉菌对青霉素已经完全耐药,对头孢噻肟和头孢曲松仍然敏感。结论 2013-2015年儿童下呼吸道感染常见致病菌为肺炎链球菌、流感嗜血杆菌以及卡他莫拉菌,各菌株对青霉素耐药明显,对头孢菌素类抗生素相对敏感,临床治疗中可优先考虑。
[Abstract]:Objective to investigate the changes of common pathogenic bacteria and drug resistance in children with lower respiratory tract infection from 2013 to 2015, and to provide scientific guidance for clinical treatment. Methods sputum samples from children with respiratory tract infection were collected for pathogen culture and bacterial identification. Drug susceptibility test was performed by disk diffusion method (K) to analyze the change of drug resistance of pathogenic bacteria. Results A total of 756 strains of pathogenic bacteria were isolated from sputum samples of patients with lower respiratory tract infection, of which 275 strains were Streptococcus pneumoniae (36.38%), 181 strains were Haemophilus influenzae (23.94%), 211 strains (27.91%) were Moraxella catarrhalis, and 7 strains were Streptococcus pneumoniae (36.38%). Other bacteria were 89 strains (11.77%). The resistance rate of Streptococcus pneumoniae to penicillin was 100.00%, and to amoxicillin, compound nomaxime, chloramphenicol, erythromycin, clindamycin, cefotaxime was 72.36%, 35.27%, 26.55%, 85.09%, respectively. 74.55% and 0.73% of the isolates were resistant to ceftriaxone and levofloxacin. The resistance rates of Haemophilus influenzae to ampicillin, rifampicin, chloramphenicol, tetracycline, cefotaxime and ceftriaxone were 59.67%, 2.76%, 22.10%, 33.15%, 0.55% and 0.55%, respectively. Ceftriaxone and cefotaxime were sensitive; Haemophilus influenzae was resistant to ampicillin and sensitive to rifampicin, ceftriaxone and cefotaxime. The resistance rates to penicillin, amoxicillin, ampicillin, rifampin, oxacillin, furantoin, cefotaxime and ceftriaxone were 100.00%, 76.67%, 73.46%, 29.38%, 35.07%, respectively. 24.17%, 1.42% and 0.95%; Moraxella catarrhalis is completely resistant to penicillin and remains sensitive to cefotaxime and ceftriaxone. Conclusion from 2013 to 2015, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis were the most common pathogens in children with lower respiratory tract infection. The strains were resistant to penicillin and relatively sensitive to cephalosporins, which could be given priority in clinical treatment.
【作者单位】：河南大学淮河医院儿科;
【分类号】：R725.6

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