摘要
目的了解某综合医院住院儿童和成人下呼吸道感染病原菌分布及耐药特征。方法回顾性分析重庆大学附属三峡医院2015年1月至2020年12月下呼吸道感染住院患者中儿童及成人痰培养所分离的病原菌构成及耐药性。结果儿童和成人患者痰培养分离的病原菌均以革兰阴性杆菌为主,分别占71.3%和91.4%,革兰阳性球菌分别占28.7%和8.6%;儿童下呼吸道感染致病菌主要是肺炎链球菌(21.9%)和流感嗜血杆菌(19.4%),而成人主要为鲍曼不动杆菌(25.3%)和肺炎克雷伯菌(24.5%);儿童肺炎链球菌对青霉素、第三代头孢菌素、碳青霉烯类药物、万古霉素、利奈唑胺、奎奴普丁/达福普汀均100%敏感,耐药率最高者依次为红霉素(96.9%)、四环素(75.8%)、复方新诺明(49.3%);流感嗜血杆菌对头孢噻肟、氧氟沙星、利福平100%敏感,耐药率最高为氨苄西林(49.8%);成人鲍曼不动杆菌对亚胺培南耐药率为79.7%,对其他抗菌药物包括第三、四代头孢菌素、氨基糖苷类等耐药率多数高于60%;肺炎克雷伯菌对亚胺培南、厄他培南和哌拉西林/他唑巴坦耐药率<15%,对其他抗菌药物包括第三、四代头孢菌素、氨基糖苷类等耐药率<40%。结论儿童和成人下呼吸道感染病原菌菌谱和耐药性差异大,经验用药时应考虑这种差异性,及时参照病原学结果合理规范治疗。
Objective To investigate the distribution and drug resistance of pathogens in children and adults with lower respiratory tract infection in a general hospital,so as to provide basis for clinical diagnosis and effective control of infection.Methods The composition and drug resistance of pathogens isolated from sputum culture of children and adults with lower respiratory tract infection in Chongqing University Three Gorges Hospital from January 2015 to December 2020 were retrospectively analyzed.Results The pathogens isolated from sputum culture of children and adults were mainly Gram-negative bacilli,accounting for 71.3%and 91.4%,respectively,followed by Gram-positive cocci,accounting for 28.7%and 8.6%,respectively.The pathogens causing lower respiratory tract infections in children were mainly Streptococcus pneumoniae(21.9%)and Haemophilus influenzae(19.4%),while those in adults were mainly Acinetobacter baumannii(25.3%)and Klebsiella pneumoniae(24.5%).Streptococcus pneumoniae in children was 100%sensitive to penicillin,the third generation cephalosporins,carbapenems,vancomycin,linezolid,and quinuppredin/duffuptin,and it was resistant to erythromycin(96.9%),tetracycline(75.8%),and compound sulfamethoxazole(49.3%).Haemophilus influenzae was 100%sensitive to cefotaxime,ofloxacin,and rifampicin,and it was resistant to ampicillin(49.8%).The resistance rate of adult Acinetobacter baumannii to imipenem was 79.7%,and its resistance rates to other antibiotics,including the third and fourth generation cephalosporins and aminoglycosides,were mostly higher than 60%.The drug resistance rates of Klebsiella pneumoniae to imipenem,ertapenem and piperacillin/tazobactam were less than 15%,and its drug resistance rates to other antimicrobial agents,including the third and fourth generation cephalosporins and aminoglycosides,were less than 40%.Conclusion There are great differences in the spectrum and drug resistance of pathogenic bacteria between children and adults with lower respiratory tract infection,which should be considered
作者
韩飞
张帅帅
HAN Fei;ZHANG Shuai-Shuai(Department of Medical Laboratory,Chongqing University Three Gorges Hospital,Chongqing 404000,CHINA)
出处
《海南医学》
CAS
2021年第17期2212-2216,共5页
Hainan Medical Journal
基金
重庆市自然科学基金(编号:cstc2019jcyj-msxmX0631)
重庆市卫生局计划项目(编号:2011-2-597)。
关键词
儿童
成人
下呼吸道感染
病原菌分布
耐药性
Children
Adults
Lower respiratory tract infection
Distribution of pathogens
Drug resistance
