| 摘要: |
| 目的:分析我院儿科支气管肺炎感染细菌的分布及耐药情况,为临床合理用药提供参考。方法:选取我院儿科2016年1-6月收治的支气管肺炎患儿1 172例,采集深部痰液标本1 001份,即送检验科检验,根据检验报告统计分析细菌的分布及耐药情况,并对临床用药进行合理性评价。结果:1 001份痰液标本分离菌株221株,阳性率为22.08%。221株病原菌中,革兰阳性菌64株(28.96%),革兰阴性菌147株(66.52%),真菌10株(4.52%);排名前5位的病原菌依次是肺炎链球菌、流感嗜血杆菌、肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌,共163株(73.76%)。肺炎链球菌对万古霉素、氯霉素、头孢曲松、头孢噻肟、氧氟沙星、左氧氟沙星、莫西沙星、利奈唑胺、泰利霉素的耐药率均为0;流感嗜血杆菌对环丙沙星、头孢曲松、左氧氟沙星、头孢他啶、头孢呋辛、氨曲南、阿奇霉素、氯霉素的耐药率均为0;铜绿假单胞菌、肺炎克雷伯菌及大肠埃希菌对碳青霉烯类、氨基糖苷类及喹诺酮类抗菌药物的耐药率较低。我院儿科治疗支气管肺炎的初始经验性用药主要为茁鄄内酰胺酶抑制剂复合制剂,占
92.06%。结论:我院儿科支气管肺炎病原菌主要有肺炎链球菌、流感嗜血杆菌、肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌,不同菌种对抗菌药物的耐药率差别明显,我院儿科治疗支气管肺炎存在过度使用抗菌药物的问题。临床医师应根据细菌药敏试验结果合理选用抗菌药物,以减少细菌耐药性的产生。 |
| 关键词: 支气管肺炎 细菌 耐药性 合理性评价 |
| DOI：doi: 10.13407/j.cnki.jpp.1672-108X.2017.12.016 |
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| 基金项目: |
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| Rational Drug Use and Etiology of Children with Bronchopneumonia in Our Hospital in January to June 2016 |
| Lin Sumei 1, Mo Hailing 1, Zhang Shouyin 2 |
| (1. National Hospital Affiliated to Guangxi Medical University, Guangxi Nanning 530001, China; 2. Guangxi Medical University, Guangxi Nanning 530001, China) |
| Abstract: |
| Objective: To analyze the distribution and drug resistance of bacteria in children with bronchopneumonia in our hospital, so as to provide reference for clinical rational drug use. Methods: A total of 1,172 cases of pediatric bronchopneumonia in our hospital in January to June 2016 were analyzed retrospectively. The deep sputum specimens of 1,001 copies were collected and sent to clinical laboratory. According to the inspection reports, distribution and drug resistance of bacteria were analyzed, and the rationality of clinical medication was evaluated. Results: Two hundred and twenty-one positive specimens (positive rate 22.08%) were isolated from 1,001
cases of secretion cultivation of bronchopneumonia, including 64 cases of gram-positive bacteria (28.96%), 147 cases of gram-negative bacteria (66.52%) and 10 cases of fungi (4.52%). The former five bacteria in distribution were Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, Escherichia coli and Pseudonas aeruginosa. The resistance rates of Streptococcus pneumoniae to vancomycin, chloramphenicol, ceftriaxone, cefotaxime, ofloxacin, levofloxacin, moxifloxacin, linezolid, telithromycin were 0. The resistance rates of Haemophilus influenzae to ciprofloxacin, ceftriaxone, levofloxacin, ceftazidime, cefuroxime, aztreonam, azithromycin and chloramphenicol were 0. The resistance rates of Pseudomonas aeruginosa, Klebsiella pneumoniae and Escherichia coli to carbapenems, aminoglycosides and quinolones were relatively low. The initial empirical drug treatment of pediatric pneumonia in our hospital was mainly beta lactamase inhibitor compound preparation, accounted for 92.06%. Conclusion: Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae, Escherichia coli and Pseudonas aeruginosa are the main pathogens of pediatric bronchial pneumonia. Excessive use of pediatric bronchial pneumonia in our hospital is existed, the clinicians should choose antimicrobial agents rationally according to the results of bacterial drug resistance monitoring. |
| Key words: bronchopneumonia bacteria drug resistance rationality evaluation |
