| 摘要: |
| 目的:了解本地区儿童社区获得性肺炎革兰阴性菌的分布及耐药性。方法:对2019 年3 月至2023 年2 月于山东第一医
科大学附属人民医院儿科住院的痰培养阳性的社区获得性肺炎患儿病历资料进行回顾性分析。结果:1 218 例患儿痰液细菌培
养阳性325 例,共分离病原菌株365 株,其中革兰阴性菌206 株,占56. 44%。前3 位分别为流感嗜血杆菌、卡他莫拉菌、大肠埃
希菌。流感嗜血杆菌及卡他莫拉菌β-内酰胺酶阳性率均较高( >80%),大肠埃希菌中超广谱β-内酰胺酶( ESBLs) 阳性率
44. 44%。流感嗜血杆菌对氨苄西林、头孢呋辛、头孢克洛、阿奇霉素耐药率较高( >70%),对头孢曲松、美罗培南敏感。大肠埃
希氏菌对美罗培南、亚胺培南、厄他培南等敏感,对哌拉西林/ 他唑巴坦不敏感率低。其中ESBLs 阳性菌株对头孢呋辛、头孢噻
肟、头孢曲松、头孢吡肟、氨曲南等的耐药率高于ESBLs 阴性菌株,差异有统计学意义(P<0. 05)。结论:本地区儿童社区获得性
肺炎革兰阴性病原菌以流感嗜血杆菌、卡他莫拉菌、大肠埃希菌为主。不同病原菌耐药性差异较大,临床应根据药敏情况选用
抗菌药物。 |
| 关键词: 社区获得性肺炎 革兰阴性菌 耐药率 儿童 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2024.10.011 |
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| 基金项目: |
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| Clinical Characteristics of Gram-Negative Pathogens in Children with Community-Acquired Pneumonia |
| Su Bo, Li Ran, Song Fuxing |
| ((People’s Hospital Affiliated to Shandong First Medical University, Jinan 271199, China)) |
| Abstract: |
| Objective: To investigate the distribution and drug resistance of Gram-negative pathogens in children with communityacquired
pneumonia. Methods: Retrospective analysis was performed on medical records of children with community-acquired
pneumonia with positive sputum culture who were hospitalized in the Pediatrics of People’s Hospital Affiliated to Shandong First Medical
University from Mar. 2019 to Feb. 2023. Results: Among the 1,218 cases, 325 cases were positive in sputum bacterial culture, 365 strains of
pathogenic bacteria were isolated, including 206 strains of Gram-negative bacteria, accounting for 56. 44%. The top 3 strains were
Haemophilus influenzae, Moraxella catarrhalis and Escherichia coli. The positive rate of β-lactamase in H. influenzae and M. catarrhalis
was higher (>80%), and the positive rate of extended-spectrum β-lactamases (ESBLs) in E. coli was 44. 44%. H. influenzae was
highly resistant to ampicillin, cefuroxime, cefaclor and azithromycin (>70%), yet sensitive to ceftriaxone and meropenem. E. coli was
sensitive to meropenem, imipenem and ertapenem, yet insensitive to piperacillin/ tazobactam. The resistance of ESBLs-positive strains to
cefuroxime, cefotaxime, ceftriaxone, cefepime and amtronam was significantly higher than that of ESBLs-negative strains, and the
difference was statistically significant (P<0. 05). Conclusion: H. influenzae, M. catarrhalis and E. coli are the main Gram-negative
pathogens of children with community-acquired pneumonia in this area. The drug resistance of different pathogens varies greatly, and
antibiotics should be selected according to drug sensitivity. |
| Key words: community-acquired pneumonia Gram-negative bacteria drug resistance children |
