中华妇幼临床医学杂志（电子版）
中華婦幼臨床醫學雜誌（電子版）
중화부유림상의학잡지（전자판）
CHINESE JOURNAL OF OBSTETRICS & GYNECOLOGY AND PEDIATRICS(ELECTRONIC VERSION)
2012年
2期
176-179
,共4页
细菌性肺炎%病原菌%耐药%儿童
細菌性肺炎%病原菌%耐藥%兒童
세균성폐염%병원균%내약%인동
bacterial pneumonia%pathogen%drug resistance%child
目的 探讨儿童细菌性肺炎的病原菌分布及耐药状况,旨在为临床诊治提供依据.方法 选择2009年1月至2010年1 2月在本院就诊并确诊为细菌性肺炎的患儿892例为研究对象.对其采用本院自行设计的《儿童细菌性肺炎调查表》进行问卷调查.采集患儿下呼吸道分泌物标本.药敏试验采用双纸片扩散法进行产超广谱β-内酰胺酶(ESBLs)试验.分别对2009和2010年本院细菌性肺炎的细菌菌株构成比及细菌株耐药率进行统计学处理,并分析本组肺炎细菌产ESBLs菌检出情况(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,并与受试对象监护人签署临床研究知情同意书).结果 892例受试者中共计135例患儿检出病原菌,检出率为15.13％,共检出病原菌10种、1 55株.其中,革兰阴性(Gˉ)菌为64.52％(100/155),革兰阳性(G+)为35.48％(55/155).检出细菌株以肺炎克雷伯菌、大肠埃希菌、肺炎链球菌、金黄色葡萄球菌、铜绿假单胞菌为主,分别占总菌株的22.58％,17.42％,14.84％,13.00％和10.97％.2009和2010年细菌菌株构成比比较,差异无统计学意义(P＞0.05).肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、肺炎链球菌和金黄色葡萄球菌等对青霉素耐药率最高,均超过80.0％,对氨苄西林、阿莫西林的耐药率均超过77.0％.2010年检出细菌株耐药率高于2009年,2009和2010年细菌株耐药率比较,差异有统计学意义(P＜0.05).本组Gˉ菌中,共检出产ESBLs菌40株,检出率为32.79％.结论 细菌性肺炎普遍耐药,而且产ESBLs菌也有一定程度流行.
目的 探討兒童細菌性肺炎的病原菌分佈及耐藥狀況,旨在為臨床診治提供依據.方法 選擇2009年1月至2010年1 2月在本院就診併確診為細菌性肺炎的患兒892例為研究對象.對其採用本院自行設計的《兒童細菌性肺炎調查錶》進行問捲調查.採集患兒下呼吸道分泌物標本.藥敏試驗採用雙紙片擴散法進行產超廣譜β-內酰胺酶(ESBLs)試驗.分彆對2009和2010年本院細菌性肺炎的細菌菌株構成比及細菌株耐藥率進行統計學處理,併分析本組肺炎細菌產ESBLs菌檢齣情況(本研究遵循的程序符閤本院人體試驗委員會所製定的倫理學標準,得到該委員會批準,併與受試對象鑑護人籤署臨床研究知情同意書).結果 892例受試者中共計135例患兒檢齣病原菌,檢齣率為15.13％,共檢齣病原菌10種、1 55株.其中,革蘭陰性(Gˉ)菌為64.52％(100/155),革蘭暘性(G+)為35.48％(55/155).檢齣細菌株以肺炎剋雷伯菌、大腸埃希菌、肺炎鏈毬菌、金黃色葡萄毬菌、銅綠假單胞菌為主,分彆佔總菌株的22.58％,17.42％,14.84％,13.00％和10.97％.2009和2010年細菌菌株構成比比較,差異無統計學意義(P＞0.05).肺炎剋雷伯菌、大腸埃希菌、銅綠假單胞菌、肺炎鏈毬菌和金黃色葡萄毬菌等對青黴素耐藥率最高,均超過80.0％,對氨芐西林、阿莫西林的耐藥率均超過77.0％.2010年檢齣細菌株耐藥率高于2009年,2009和2010年細菌株耐藥率比較,差異有統計學意義(P＜0.05).本組Gˉ菌中,共檢齣產ESBLs菌40株,檢齣率為32.79％.結論 細菌性肺炎普遍耐藥,而且產ESBLs菌也有一定程度流行.
목적 탐토인동세균성폐염적병원균분포급내약상황,지재위림상진치제공의거.방법 선택2009년1월지2010년1 2월재본원취진병학진위세균성폐염적환인892례위연구대상.대기채용본원자행설계적《인동세균성폐염조사표》진행문권조사.채집환인하호흡도분비물표본.약민시험채용쌍지편확산법진행산초엄보β-내선알매(ESBLs)시험.분별대2009화2010년본원세균성폐염적세균균주구성비급세균주내약솔진행통계학처리,병분석본조폐염세균산ESBLs균검출정황(본연구준순적정서부합본원인체시험위원회소제정적윤리학표준,득도해위원회비준,병여수시대상감호인첨서림상연구지정동의서).결과 892례수시자중공계135례환인검출병원균,검출솔위15.13％,공검출병원균10충、1 55주.기중,혁란음성(Gˉ)균위64.52％(100/155),혁란양성(G+)위35.48％(55/155).검출세균주이폐염극뢰백균、대장애희균、폐염련구균、금황색포도구균、동록가단포균위주,분별점총균주적22.58％,17.42％,14.84％,13.00％화10.97％.2009화2010년세균균주구성비비교,차이무통계학의의(P＞0.05).폐염극뢰백균、대장애희균、동록가단포균、폐염련구균화금황색포도구균등대청매소내약솔최고,균초과80.0％,대안변서림、아막서림적내약솔균초과77.0％.2010년검출세균주내약솔고우2009년,2009화2010년세균주내약솔비교,차이유통계학의의(P＜0.05).본조Gˉ균중,공검출산ESBLs균40주,검출솔위32.79％.결론 세균성폐염보편내약,이차산ESBLs균야유일정정도류행.
Objective To explore pathogens causing bacterial pneumonia in children and drug resistance in hospital,and supply evidence on diagnosis and therapy of a clinical basis.Methods From January 2009 to December 2010,a total of 892 children with bacterial pneumonia were involved in this study.All subjects were investigation by Questionnaire of Bacterial Pneumonia in Children and sample were collected.Antimicrobial susceptibility of antibiotics was detected by Kirby-Bauer method.Producing extended spectrum β-lactamases (ESBLs) bacteria were identified by double-disk synergy test.The procedure of this study was consistent with ethical standard established by the committee of investigation in human beings of Obstetrics and Gynecology Hospital of Hainan Province.And it was approved by this committee.Guardians or patients were informed of grouping and their written informed consent was obtained before clinical studies.Results A total of 155 pathogenic bacteria strains were isolated from 135 children,and isolation rate was 15.13％.The top five bacterial strains were Klebsiella pneumoniae,Escherichia coli,Streptococcus pneumoniae,Staphylococcus aureus and Pseudomonas aeruginosa,which accounted for 22.58％,17.42％,14.84％,13.00％ and 10.97％ of the total bacteria strains,respectively.Drug resistance rates of Klebsiella pneumoniae,Escherichia coli,Streptococcus pneumoniae,Sta ph ylococcus aureus and Pseudomonas aeruginosa were much more than 80％ to penicillin,while much more than 77.0％ to Ampicillin and amoxicillin.Drug resistance rate in 2010 was much more than that in 2009.A total of 40 producing ESBLs bacteria strains were identified by double-disk synergy test among tep five bacterial with the detection rate of 32.79％.Conclusions All of the bacterial pneumonia in children have the drug resistant feature,and producing ESBLs bacteria are at prevalence to a certain extent.
