摘要
目的:调查清远市儿童社区获得性肺炎病原体,同时分析患儿的细菌耐药性。方法:随机选择笔者所在医院2017年8月-2019年9月接诊的儿童社区获得性肺炎患儿2 000例为临床观察对象,对儿童的病原体进行采样检测,分析患儿的病原体分布情况及细菌耐药性。结果:2 000例患儿共检出2 229株病原体,包括细菌899株(40.33%),病毒750株(33.65%),非典型病原体556株(24.94%),真菌24株(1.08%)。899株细菌中,构成比居前5位的分别是流感嗜血杆菌、肺炎链球菌、金黄色葡萄球菌、大肠埃希菌、肺炎克雷伯菌。药敏试验结果显示,金黄色葡萄球菌对青霉素、红霉素、四环素具有较高的耐药性;肺炎链球菌对克林霉素、红霉素、四环素具有较高的耐药性;但两者对万古霉素及利奈唑胺均能保持良好的敏感性。大肠埃希菌对青霉素、红霉素、头孢唑林具有较高的耐药性;肺炎克雷伯对青霉素、头孢唑林、头孢呋辛具有较高的耐药性;流感嗜血杆菌对青霉素、氨苄西林、头孢唑林具有较高的耐药性,但三者对头孢哌酮舒巴坦、美罗培南等碳青霉烯类抗菌药物及阿米卡星仍保持良好的敏感性。结论:清远市儿童社区获得性肺炎的致病因素主要为细菌感染,并以流感嗜血杆菌最多;其次为病毒,主要是呼吸道合胞病毒和腺病毒;非典型病原体以肺炎支原体为主。临床上进行治疗的过程中,要考虑当地常见病原体及常见细菌耐药的情况,才能更有针对性地选择治疗,做到对症下药,实现治疗效果的提升。
Objective:To investigate the pathogens of community-acquired pneumonia in children in Qingyuan city,and analyze the bacterial resistance of children.Method:A total of 2000 children with community-acquired pneumonia admitted in our hospital from August 2017 to September 2019 were randomly selected as the clinical observation subjects.The pathogens of children were sampled and tested to analyze the pathogens distribution and bacterial resistance of children.Result:A total of 2229 strains of pathogens were detected in 2000 children,including 899 strains(40.33%)of bacterial,750 strains(33.65%)of virus,556 strains(24.94%)of atypical pathogens and 24 strains(1.08%)of fungi.Among the 899 strains of bacterial,the top 5 bacterial were Haemophilus influenzae,Streptococcus pneumoniae,Staphylococcus aureus,Escherichia coli and Klebsiella pneumoniae.The results of drug sensitivity test showed that Staphylococcus aureus had high resistance to Penicillin,Erythromycin and Tetracycline.Streptococcus pneumoniae had high resistance to Clindamycin,Erythromycin and Tetracycline,but both of them were sensitive to Vancomycin and Linezolid.Escherichia coli had high resistance to Penicillin,Erythromycin and Cefazolin.Klebsiella pneumoniae had high resistance to Penicillin,Cefazolin and Cefuroxime.Haemophilus influenzae had high resistance to Penicillin,Ampicillin and Cefazolin.However,three of them were sensitive to Cefoperazone Sulbactam,Meropenem and other carbapenems and Amikacin.Conclusion:The pathogenic factors of community-acquired pneumonia in children in Qingyuan City were mainly bacterial infection,with Haemophilus influenzae being the most common.The second is virus,mainly Respiratory syncytial virus and Adenovirus.The atypical pathogens are mainly mycoplasma pneumoniae.In the process of clinical treatment,it is necessary to consider the local common pathogens and common bacterial resistance,so that more targeted treatment can be selected,so as to achieve the appropriate treatment and improve the treatment effect.
作者
谢旋生
戴洪法
米沛明
廖翠乐
XIE Xuansheng;DAI Hongfa;MI Peiming;LIAO Cuile(Qingyuan Maternal and Child Health Care Hospital,Qingyuan 511500,China;不详)
出处
《中外医学研究》
2020年第22期68-70,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
清远市科技计划项目(2018B099)。
关键词
儿童社区获得性肺炎
细菌感染
病原体
细菌耐药性
Community-acquired pneumonia in children
Bacterial infection
Pathogens
Bacterial resistance
