| 摘要: |
| 目的：总结我院儿童社区获得性肺炎病原菌分布特点及变迁，以指导抗菌药物合理使用。方法：统计2013年、2015年、2017年我院收治的2 786例肺炎患儿临床资料，进行痰培养及药敏试验，比较3年病例的病原菌分布特点及耐药性变迁。结果：肺炎以婴幼儿为主，占59.9%，冬春季占61.5%；共630例（22.6%）检出病原菌，其中G-占67.9%；前3位致病菌为金黄色葡萄球菌（28.1%）、大肠埃希菌（19.2%）、肺炎克雷伯菌肺炎亚种（16.1%）；金黄色葡萄球菌、铜绿假单胞菌、鲍曼不动杆菌及流感嗜血杆菌检出率逐年上升；金黄色葡萄球菌对阿莫西林/克拉维酸钾耐药率均<15%，肺炎克雷伯菌肺炎亚种及大肠埃希菌对阿莫西林/克拉维酸钾和哌拉西林/他唑巴坦耐药率均<20%，对头孢菌素耐药率较高但逐年下降。主要G-对大部分抗生素耐药率逐年下降（P<0.05）。结论：儿童社区获得性肺炎发病人群以婴幼儿为主，病原菌以G-较多，主要致病G-耐药率呈逐年下降趋势，含β内酰胺酶抑制剂类抗生素可作为首选抗生素。 |
| 关键词: 儿童 肺炎 病原菌 耐药 变迁 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2020.06.015 |
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| 基金项目: |
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| Changes of Pathogens and Drug Resistance of Community-Acquired Pneumonia in Children |
| Xu Qingqing, Peng Chunyan, Su Yongchun, Fang Juan, Zhou Weijun |
| (Chongqing Yubei District People’s Hospital, Chongqing 401120, China) |
| Abstract: |
| Objective: To summarize the distribution characteristics and changes of pathogens of community-acquired pneumonia in children from our hospital, so as to guide the rational application of antibiotics. Methods: Clinical data of 2,786 children with pneumonia in our hospital in 2013, 2015 and 2017 were statistically analyzed. Sputum culture and drug sensitivity test were performed. The distribution characteristics of pathogens and changes of drug resistance were compared at 3 years. Results: The majority of patients with pneumonia were infants, accounting for 59.9%. And the proportion was 61.5% in winter and spring. A total of 630 cases (22.6%) were diagnosed with pathogens, of which G- accounted for 67.9%. The top three pathogens were respectively Staphylococcus aureus (28.1%), Escherichia coli (19.2%) and Klebsiella pneumoniae (16.1%). The detection rate of S. aureus, Pseudomonas aeruginosa, Acinetobacter baumannii and Haemophilus influenzae increased year by year. Drug resistance rates of S. aureus to amoxicillin/potassium clavulanate were <15%, drug resistance rates of K. pneumoniae and Escherichia coli to amoxicillin/potassium clavulanate and piperacillin/tazobactam were <20%, and drug resistance rates of K. pneumoniae and E. coli to cephalosporin were higher but in a decreasing trend year by year. The resistance rate of major G- to most antibiotics decreased year by year (P<0.05). Conclusion: The majority of children with community-acquired pneumonia are infants and young children, and the pathogens are mostly G-. Drug resistance rates of main pathogens G- are decreasing year by year. Antibiotics containing β-lactamase inhibitors can be used as the first options. |
| Key words: children pneumonia pathogens drug resistance changes |
