| 摘要: |
| 目的:了解泸州地区儿童下呼吸道感染细菌病原的分布及耐药情况。方法:采用回顾性研究方法,收集2013 年7 月至
2018 年6 月因下呼吸道感染入住西南医科大学附属医院儿科的患儿痰液细菌培养及药敏试验结果16 418 份,分析常见细菌的
耐药情况。结果:16 418 份痰标本中,5 298 份(32. 3%) 检出细菌或真菌( 真菌相对较少,暂不重点讨论)。其中,革兰阳性菌
2 076 株(39. 2%),主要为金黄色葡萄球菌1 148 株、肺炎链球菌848 株等;革兰阴性菌2 766 株(52. 2%),主要为大肠埃希菌
858 株、肺炎克雷伯菌857 株等。金黄色葡萄球菌对头孢西丁、氨苄西林、青霉素、克林霉素、红霉素的耐药率较高( >60%),对
苯唑西林、头孢曲松敏感率较高(>74%)。肺炎链球菌对克林霉素、红霉素的耐药率高( >80%),对碳青霉烯类抗菌药物、青霉
素、头孢呋辛、头孢曲松高度敏感(>98%)。暂未发现对利奈唑胺及万古霉素耐药的金黄色葡萄球菌或肺炎链球菌。大肠埃希
菌、肺炎克雷伯菌、铜绿假单胞菌对第三代、第四代头孢菌素的敏感率均<67%。铜绿假单胞菌对碳青霉烯类抗菌药物的耐药率
较高(16. 9%~34. 6%)。结论:泸州地区儿童下呼吸道感染细菌病原以革兰阴性菌为主,临床应同时监测细菌对常用抗菌药物
的耐药性和敏感性,促进抗菌药物合理应用,及时控制细菌病原的传播。 |
| 关键词: 下呼吸道感染 细菌 耐药性 儿童 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2023.01.014 |
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| 基金项目: |
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| Distribution and Drug Resistance of Common Bacterial Pathogens in 16,418 Hospitalized Children with Lower Respiratory Tract Infection |
| Jiang Qing1, Zhou Lifang1, Wang Dan1, Luo Xiaomei1, Gong Yao1, Fu Hua1, Chen Ai2 |
| (1. Affiliated Hospital of Southwest Medical University, Sichuan Luzhou 646000, China; 2. Sichuan Provincial Maternity and Child Health Care Hospital,Chengdu 610031, China) |
| Abstract: |
| Objective: To explore the distribution and drug resistances/ sensitivities of bacterial pathogens in the lower respiratory tract
infection of hospitalized children in Luzhou. Methods: A total of 16,418 sputum samples were collected from hospitalized children
admitted to the department of Pediatrics, Affiliated Hospital of Southwest Medical University, with lower respiratory tract infections from
July 2013 to June 2018. Results: A total of 16,418 sputum samples were detected, of which 5,298 samples were positive, and the
positive rate was 32. 3%. Among them, 2,076 cases (39. 2%) were Gram-positive bacteria, of which 1,148 (21. 7%) Staphylococcus
aureus and 848 (16. 0%) Streptococcus pneumoniae were the main strains. 2,766 (52. 2%) were Gram-negative bacteria, of which 858
Escherichia coli and 857 Klebsiella pneumonia were the main strains. The drug resistance rate of Staphylococcus aureus to cefoxitin,
ampicillin, penicillin, clindamycin, and erythromycin was over than 60%, while it was sensitive to oxacillin and cefatriaxone (>74%).
Streptococcus pneumonia was resistant to clindamycin and erythromycin (>80%), while highly sensitive to carbapenems, penicillin,
cefuroxime and cefatriaxone (>98%). No Staphylococcus aureus or Streptococcus pneumonia strains were found resistant to linezolid or
vancomycin. The sensitivity rate of Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa to the third and fourth generation
cephalosporins was less than 67%. The drug resistance rates of Pseudomonas aeruginosa to carbapenems were up to 16. 9% to 34. 6%.
Conclusion: Gram-negative bacteria were the dominating bacterial pathogens of lower respiratory tract infection in children. The
resistance and sensitivity of bacterial pathogens to antibiotics should be monitored simultaneously to promote the rational use of antibiotics and limit the spread of antibiotic pathogens. |
| Key words: lower respiratory tract infection bacteria drug resistance children |
