摘要
目的探讨健康学龄前儿童入托期间发生AURI前后咽部菌群及其药敏结果变化,为抗生素合理使用提供理论依据。方法 119名健康学龄前儿童在入托前体检时、入托48h后首次发生AURI时采集咽拭子标本行细菌培养鉴定及药物敏感试验,分析发病前后咽部细菌构成比例及药物敏感性的变化。结果 91名儿童首次AURI发病后咽拭子培养分离2+及以上细菌菌株与入托前体检差别具有统计学意义(χ2=4.607,P=0.032)。发病前咽部定植菌主要有草绿色链球菌、黏膜炎莫拉菌、肺炎链球菌等,发病后新增乙型溶血性链球菌、大肠埃希菌、化脓性链球菌、光滑假丝酵母菌,仅乙型溶血性链球菌前后比例差别有统计学意义(χ2=7.280,P=0.014)。对半定量分析2+及以上的细菌行药敏试验后发现细菌对常见抗菌素不同程度耐药。分析数量前三位的草绿色链球菌、黏膜炎莫拉菌以及肺炎链球菌敏感结果,草绿色链球菌对头孢噻肟、黏膜炎莫拉菌对青霉素及头孢呋辛发病后药物敏感性较发病前下降具有统计学意义(P值分别为0.029、0.048、0.029),其余细菌前后药敏差异均无统计学意义。结论儿童入托期间首次AURI后咽拭子培养细菌数量及种类较感染前明显增加,发病后细菌对常见抗生素耐药率加重,应重视规范抗生素的使用。
Objective To explore the changes of pharyngeal flora and its drug sensitivity before and after acute upper respiratory tract infection(AURI) in preschoolers, in order to provide theoretical basis for the rational use of antibiotics. Methods The throat swab samples were collected for bacterial culture and drug sensitivity test at the time of physical examination and the first occurrence of AURI after entering the nursery for 48 hours in 119 healthy preschoolers, the changes in pharyngeal bacteria composition and drug sensitivity before and after the AURI were analyzed. Results There was a significant difference between the 2+ and more bacterial strains by throat swab cultures in the physical examinations before boarding and after the first onset of AURI in 91 children(χ~2=4.607, P=0.032). The colonized bacteria in the pharynx before AURI mainly included Streptococcus viridis, S. catarrhalis, and Streptococcus pneumoniae. The newly and added bacteria after AURI were hemolytic Streptococcus B, Escherichia coli, Streptococcus pyogenes, and Candida glabrata. There were significant differences only in the proportion of hemolytic Streptococcus B before and after AURI(χ~2=7.280, P=0.014). It was found that bacteria were resistant to common antibiotics in varying degrees after drug sensitivity test. Sensitivity analysis of the top three strains of S. viridis, S. catarrhalis, and S. pneumoniae showed that the drug sensitivity of Streptococcus viridis to cefotaxime and catamora to penicillin and cefuroxime decreased significantly(P=0.029, 0.048, 0.029) compared with that before the onset of the disease, there was no significant difference in drug resistance of other bacteria. Conclusion The number and species of bacteria cultured in pharynx swab after the first AURI in children were significantly higher than those before infection, and the resistance rates of bacteria to common antibiotics increased after the onset of the disease. Therefore, attention should be paid to standardizing the use of antibiotics.
作者
罗春绸
蔡梦云
张月葵
林英
张丽芬
林秀梅
蔡惠贞
Luo Chun-chou;Cai Meng-yun;Zhang Yue-kui;Lin Ying;Zhang Li-fen;Lin Xiu-mei;Cai Hui-zhen(Zhangzhou Municipal Hospital Affiliated to Fujian Medical University,Zhangzhou 363000)
出处
《中国抗生素杂志》
CAS
CSCD
2020年第11期1197-1200,I0001,共5页
Chinese Journal of Antibiotics
基金
福建省自然科学基金资助项目(No.2017J01387)。
关键词
入托
急性上呼吸道感染(AURI)
咽部菌群
药敏试验
Admission
Acute upper respiratory tract infection(AURI)
Pharyngeal flora
Drug sensitivity test
