[1]宋艳玲.小儿下呼吸道感染病原菌特征及药敏试验分析*[J].陕西医学杂志,2020,49(1):47-51.
　SONG Yanling..Analysis of characteristics and drug sensitivity test of pathogenic bacteria in children with lower respiratory tract infection[J].,2020,49(1):47-51.
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小儿下呼吸道感染病原菌特征及药敏试验分析*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
49
期数:
2020年1期
页码:
47-51
栏目:
临床研究
出版日期:
2020-01-05

文章信息/Info

Title:
Analysis of characteristics and drug sensitivity test of pathogenic bacteria in children with lower respiratory tract infection
文章编号:
DOI:10.3969/j.issn.10007377.2020.01.013
作者:
宋艳玲
陕西省商洛市中心医院（商洛 726000）
Author(s):
SONG Yanling.
Shangluo Central Hospital of Shaanxi Province（Shangluo 726000）
关键词:
小儿; 感染疾病; 下呼吸道; 病原菌; 年龄; 季节性; 耐药性
Keywords:
Key words Pediatric; Infectious disease; Lower respiratory tract; Pathogenic bacteria; Age; Seasonality; Drug resistance
分类号:
R725.6
文献标志码:
A
摘要:
摘 要 目的：探讨小儿下呼吸道感染病原菌与年龄和季节性分布特征及耐药性，为7岁以下小儿下呼吸道感染的预防及治疗提供依据。方法：选择下呼吸道感染患儿1152例为研究对象。采集其痰液样本进行病原菌培养及药敏试验分析。分析不同年龄段、不同季节病原菌分布情况及总体耐药性。结果：共分离到766株病原菌。肺炎克雷伯菌、流感嗜血杆菌、铜绿假单胞菌、大肠埃希菌、阴沟肠杆菌、肺炎链球菌、金黄色葡萄球菌分离率在＜1个月、1个月至1岁、1~3岁、3~7岁患儿间差异具有统计学意义（P＜0.01），各病原菌分离数量以1岁以内婴幼儿较多，3~7岁学龄前小儿较少。肺炎克雷伯菌、流感嗜血杆菌、铜绿假单胞菌、大肠埃希菌、阴沟肠杆菌、肺炎链球菌、金黄色葡萄球菌、白色假丝酵母分离率在春、夏、秋、冬四季间差异均具有统计学意义（P＜0.01），其中肺炎克雷伯菌、铜绿假单胞菌以秋季分离率较高，流感嗜血杆菌、肺炎链球菌、金黄色葡萄球菌冬季分离率较高。肺炎克雷伯菌对氨苄西林、头孢呋辛均有极强耐药（耐药率＞98%），对哌拉西林/他唑巴坦、阿米卡星敏感性极强（耐药率＜8%）；流感嗜血杆菌对头孢唑林、复方磺胺甲噁唑有较强耐药性（68.24%、61.49%），对哌拉西林/他唑巴坦、头孢他啶、头孢吡肟、头孢呋辛、头孢曲松、亚胺培南有极强敏感性（耐药率＜10%）；铜绿假单胞菌对氨苄西林、头孢唑林、复方磺胺甲噁唑有极强耐药性（100.00%、94.52%、98.63%），对阿米卡星、亚胺培南有极强敏感性（耐药率＜3%）；肺炎链球菌和金黄色葡萄球菌均对青霉素、红霉素和克林霉素耐药率均＞70%，对左氧氟沙星、万古霉素、利奈唑胺、利福平有极强敏感性（耐药率＜5%）。结论：7岁以下小儿下呼吸道感染主要病原菌分布具有年龄及季节性差异，儿科临床治疗中应依据药敏试验结果选择合适的抗菌药物。
Abstract:
Abstract Objective:To investigate the age and seasonal distribution characteristics and drug resistance of pediatric pathogens in lower respiratory tract infection，in order to provide evidence for the prevention and treatment of lower respiratory tract infections under 7 years old in this city.Methods:1152 children with lower respiratory tract infection admitted to the pediatric outpatient department were selected as subjects.The sputum samples were collected for pathogen culture and drug sensitivity test analysis.The distribution of pathogenic bacteria and the overall drug resistance of different age groups and different seasons were analyzed.Results:A total of 766 pathogenic bacteria were isolated.The isolation rate of Klebsiella pneumoniae，Haemophilus influenzae，Pseudomonas aeruginosa，Escherichia coli，Enterobacter cloacae，Streptococcus pneumoniae，Staphylococcus aureus had statistic difference between ＜1 month children，1 month to 1 year old children，1 to 3 years old children，3 to 7 years old children(P＜0.01),and the number of pathogens isolated from infants within 1 year of age was high，and fewer strains were isolated from preschool children aged 3 to 7 years.The isolation rate of Klebsiella pneumoniae，Haemophilus influenzae，Pseudomonas aeruginosa，Escherichia coli，Enterobacter cloacae，Streptococcus pneumoniae，Staphylococcus aureus，Candida albicans had statistic difference between spring，summer，autumn，winter seasons(P＜0.01)，and among those，Klebsiella pneumoniae and Pseudomonas aeruginosa have higher isolation rate in autumn，and Haemophilus influenzae，Streptococcus pneumoniae and Staphylococcus aureus have higher separation rate in winter.Klebsiella pneumoniae 〖LM〗was highly resistant to ampicillin and cefuroxime(resistance rate ＞98%)，and was highly sensitive to piperacillin/tazobactam and amikacin(resistance rate＜ 8%);Haemophilus influenzae was highly resistant to cefazolin and compound sulfamethoxazole(68.24%,61.49%)，was strongly sensitive to piperacillin/tazobactam，ceftazidime，cefepime，cefuroxime，ceftriaxone and imipenem(resistance rate ＜10%);Pseudomonas aeruginosa was highly resistant to ampicillin，cefazolin，and compound sulfamethoxazole(100.00%，94.52%，98.63%)，and was highly sensitive to amikacin and imipenem(resistance rate ＜3%);Both S.pneumoniae and Staphylococcus aureus had resistance rates of ＞70% to penicillin，erythromycin and clindamycin，and were highly sensitive to levofloxacin，vancomycin，linezolid and rifampicin(resistance rate ＜5%).Conclusion:The distribution of major pathogens in lower respiratory tract infections in children under 7 years of age has age and seasonal differences.In pediatric clinical treatment，appropriate antibacterial drugs are should be based on the results of specific drug susceptibility tests.

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备注/Memo

备注/Memo:
*陕西省卫生和计划生育委员会科研项目(2015JM40186)
更新日期/Last Update: 2020-02-17