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急性重症患儿下呼吸道感染病原菌及耐药性分析

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目的 探讨急性重症下呼吸道感染病原菌分布情况及耐药性.方法 选取2014年10月~2016年12月天津市第五中心医院441例急性重症下呼吸道感染患儿,经一次性吸痰管或容器经口部气管插管抽取患儿下呼吸道分泌物,进行细菌培养及鉴定,明确其菌属类型,并进行药敏试验.结果 本组441例患儿共培养出642株病原菌,其中,革兰阴性菌共391株,占60.90%(391/642),主要包括铜绿假单胞菌(17.45%)、鲍氏不动杆菌(14.80%)、肺炎克雷伯菌(13.86%);革兰阳性菌共150株,占23.36%(150/642),主要包括金黄色葡萄球菌(15.58%).革兰阴性菌多为耐药菌及多药耐药菌,对哌拉西林及亚胺培南耐药性相对较低.革兰阳性菌对青霉素、庆大霉素、红霉素等耐药性均较高,对万古霉素耐药性均较低,其中,金黄色葡萄球菌、表皮葡萄球菌、粪肠球菌对万古霉素耐药性均为0.00%.结论 急性重症患儿下呼吸道感染病原菌主要以铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌等革兰阴性菌为主,临床应根据病原菌种属及药敏试验结果合理选择抗菌药物对患儿进行治疗.
Analysis of pathogens and drug resistance of lower respiratory tract infection in children with severe acute respiratory syndrome
Objective To investigate the distribution of pathogens in acute severe lower respiratory tract infection and drug resistance.MethodsFrom October 2014 to December 2016, selected 441 children patients with acute severe lower respiratory tract infectionin tianjinfifth centralhospital were drawn lower respiratory tract secretions from the oral endotracheal intubation of the disposable suction tube or container, bacterial culture and identification, to determine the type of bacteria, and drug susceptibility test.ResultsA total of 642pathogens were co-cultured in 441 children, of which 391 were Gram-negative bacteria, accounting for 60.90% (391/642), including Pseudomonas aeruginosa (17.45%), Acinetobacterbaumannii (14.80 %), Klebsiellapneumoniae (13.86%);Gram-positive bacteria were 150 strains, accounting for 23.36% (150/642), mainly including Staphylococcus aureus (15.58%).Gram-negative bacteria are mostly resistant bacteria and multidrug-resistant bacteria, piperacillin and imipenem resistance is relatively low.Gram-positive bacteria on penicillin, gentamicin, erythromycin and other drug resistance are high, resistance to vancomycin are low, including Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis Resistant drug resistance were 0.00%.ConclusionThe pathogens of lower respiratory tract infection in children with acute severe disease mainly include Pseudomonas aeruginosa, Acinetobacterbaumannii and Klebsiellapneumoniae and other Gram-negative bacteria, the clinical application should be based on the results of pathogen species and susceptibility test to choose reasonable antimicrobial drugs for children patients.

acute severe lower respiratory tract infectionpathogendrug resistance

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天津医科大学研究生院,天津300070

天津市第五中心医院检验科,天津300450

急性重症下呼吸道感染 病原菌 耐药性

2017

中国生化药物杂志
南京生物化学制药研究所,全国生化制药情报中心站,中国生化制药工业协会,中国药品生物制品检定所

中国生化药物杂志

ISSN:1005-1678
年,卷(期):2017.(5)
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