摘要
目的了解住院患儿呼吸道感染病原菌分布及耐药性,为临床经验性治疗提供参考。方法对2011年至2015年住院患儿呼吸道标本分离出的病原菌进行细菌鉴定及药敏分析。结果6 236份标本分离出病原菌1 995株,阳性率为31.99%。1 281株(64.21%)来自男性,714株(35.79%)来自女性。患儿年龄1 d^14岁,平均年龄(1.2±2.1)岁,其中小于1岁的患儿有1 393例(69.82%)。1 995株病原菌中革兰阴性菌1 016株(50.93%),革兰阳性菌704株(35.29%),真菌275株(13.78%)。分离率前5位病原菌依次为金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌、白色念珠菌及鲍曼不动杆菌,分别占29.82%、15.09%、13.18%、12.73%和5.91%。金黄色葡萄球菌对苯唑西林的耐药率为31.76%,对万古霉素和利奈唑胺100.00%敏感。主要革兰阴性菌对亚胺培南耐药率为1.52%~5.93%,对头孢他啶、头孢吡肟、哌拉西林/他唑巴坦和妥布霉素耐药率<30.00%。结论住院患儿呼吸道感染人群中1岁以内婴儿比例较高,且男性多于女性。分离的病原菌以金黄色葡萄球和肠杆菌属为主,不同菌种对抗菌药物耐药率各有差异,临床应参照药敏结果合理选用抗菌药物。
Objective To investigate the distribution and drug resistance of the pathogens isolated from hospitalized pediatric patients with respiratory tract infections,and to provide guidance for empiric therapy. Methods Respiratory tract specimens from hospitalized pediatric patients with respiratory tract infections from 2011 to 2015 were collected,and the strains were identified and the drug susceptibility was tested. Results A total of 1995 strains of pathogens,1281（ 64. 21%） from boys and 714（ 35. 79%） from girls,were isolated from 6236 specimens and the detection rate was 31. 99%. The mean age of the hospitalized pediatric patients was（ 1. 22 ± 2. 05） years（ ranged from 1 day to 14 years）. 1393（ 69. 82%）pediatric patients were younger than 1 year. Staphylococcus aureus,Escherichia coli,Klebsiella pneumoniae,Candida albicans and Acinetobacter baumannii ranked the top five species, accounting for 29. 82%,15. 09%,13. 18%,12. 73% and 5. 91%,respectively. 1995 strains included gram-negative bacteria（ 50. 93%）, gram-positive bacteria（ 35. 29%）, and fungi（ 13. 78%）. The resistance rate of Staphylococcus aureus to oxacillin was 31. 76%,but it was 100% sensitive to vancomycin and linezolid. The resistant rate of gram-negative bacteria to imipenem was ranged from 1. 52% to 5. 93%. The resistantrate of gram-negative bacteria to ceftazidime,cefepime,piperacillin tazobactam and tobramycin was less than30. 00%. Conclusions The infants whose age are younger than 1 year comprise the majority of the hospitalized pediatric patients with respiratory tract infections. The proportion of male is more than that of female. Staphylococcus aureus and enterobacteriaceae were the main isolated pathogens. There is difference in drug resistance between different pathogens,so antibiotics should be chosen according to the results of drug sensitivity testing.
作者
张秀红
李朗
董亮
耿先龙
Zhang Xiuhong Li Lang Dong Liang Geng Xianlong(Department of Pharmacy, Wuxi People＇ s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu, 214023, China)
出处
《中国呼吸与危重监护杂志》
CAS
北大核心
2016年第6期572-576,共5页
Chinese Journal of Respiratory and Critical Care Medicine
基金
国家自然科学基金(编号:81400054)
江苏省自然科学基金(编号:BK20140122)
无锡市卫生局妇幼保健项目(编号:FYKY201405)
关键词
住院患儿
呼吸道感染
病原菌
耐药性
Hospitalized pediatric patients
Respiratory tract infection
Pathogen
Drug resistance
