中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2014年
15期
9-10
,共2页
社区获得性肺炎%细菌培养/痰%耐药性
社區穫得性肺炎%細菌培養/痰%耐藥性
사구획득성폐염%세균배양/담%내약성
Community-acquired pneumonia%Bacterial culture/Sputum%Drug-resistant
目的：了解儿童社区获得性肺炎常见病原菌分布及耐药情况，为临床合理应用抗菌药物提供依据。方法对570例儿童社区获得性肺炎的痰标本进行培养并做药敏试验。结果570例标本共检出致病菌224株，总阳性率为39.3%，其中革兰阳性菌、革兰阴性菌分别占28.2%、71.8%。主要致病菌依次为肺炎克雷伯菌47株、大肠埃希菌25株、产酸克雷伯菌18株、表皮葡萄球菌18株、中间葡萄球菌14株、金黄色葡萄球菌12株。肺炎克雷伯菌和大肠埃希菌、产酸克雷伯菌产超广谱β-内酰胺酶（ESBLs）阳性率分别为：59.6%（28/47）、64%（16/25）、55.6%（10/18）。耐甲氧西林金黄色葡萄球菌MRSA为0%，耐甲氧西林凝固酶阴性葡萄球菌株（MRCON）52.9%（27/51）。前3位革兰阴性菌对哌拉西林他唑巴坦、头孢哌酮/舒巴坦、阿米卡星敏感度高，对氨苄西林耐药率达100%；对头孢类（除头孢西丁外）及氨曲南耐药率几乎均超过50%。金黄色葡萄球菌对青霉素均耐药。表皮葡萄球菌的耐药性明显高于金黄色葡萄球菌。结论儿童社区获得性肺炎致病菌以革兰阴性菌为主，主要病原菌有较强耐药性。加强细菌监测分析，有利于指导临床合理用药及对多重耐药菌的管理。
目的：瞭解兒童社區穫得性肺炎常見病原菌分佈及耐藥情況，為臨床閤理應用抗菌藥物提供依據。方法對570例兒童社區穫得性肺炎的痰標本進行培養併做藥敏試驗。結果570例標本共檢齣緻病菌224株，總暘性率為39.3%，其中革蘭暘性菌、革蘭陰性菌分彆佔28.2%、71.8%。主要緻病菌依次為肺炎剋雷伯菌47株、大腸埃希菌25株、產痠剋雷伯菌18株、錶皮葡萄毬菌18株、中間葡萄毬菌14株、金黃色葡萄毬菌12株。肺炎剋雷伯菌和大腸埃希菌、產痠剋雷伯菌產超廣譜β-內酰胺酶（ESBLs）暘性率分彆為：59.6%（28/47）、64%（16/25）、55.6%（10/18）。耐甲氧西林金黃色葡萄毬菌MRSA為0%，耐甲氧西林凝固酶陰性葡萄毬菌株（MRCON）52.9%（27/51）。前3位革蘭陰性菌對哌拉西林他唑巴坦、頭孢哌酮/舒巴坦、阿米卡星敏感度高，對氨芐西林耐藥率達100%；對頭孢類（除頭孢西丁外）及氨麯南耐藥率幾乎均超過50%。金黃色葡萄毬菌對青黴素均耐藥。錶皮葡萄毬菌的耐藥性明顯高于金黃色葡萄毬菌。結論兒童社區穫得性肺炎緻病菌以革蘭陰性菌為主，主要病原菌有較彊耐藥性。加彊細菌鑑測分析，有利于指導臨床閤理用藥及對多重耐藥菌的管理。
목적：료해인동사구획득성폐염상견병원균분포급내약정황，위림상합리응용항균약물제공의거。방법대570례인동사구획득성폐염적담표본진행배양병주약민시험。결과570례표본공검출치병균224주，총양성솔위39.3%，기중혁란양성균、혁란음성균분별점28.2%、71.8%。주요치병균의차위폐염극뢰백균47주、대장애희균25주、산산극뢰백균18주、표피포도구균18주、중간포도구균14주、금황색포도구균12주。폐염극뢰백균화대장애희균、산산극뢰백균산초엄보β-내선알매（ESBLs）양성솔분별위：59.6%（28/47）、64%（16/25）、55.6%（10/18）。내갑양서림금황색포도구균MRSA위0%，내갑양서림응고매음성포도구균주（MRCON）52.9%（27/51）。전3위혁란음성균대고랍서림타서파탄、두포고동/서파탄、아미잡성민감도고，대안변서림내약솔체100%；대두포류（제두포서정외）급안곡남내약솔궤호균초과50%。금황색포도구균대청매소균내약。표피포도구균적내약성명현고우금황색포도구균。결론인동사구획득성폐염치병균이혁란음성균위주，주요병원균유교강내약성。가강세균감측분석，유리우지도림상합리용약급대다중내약균적관리。
Objective The objective of this paper is to investigate the characteristics of pathogenic bacteria and drug resistance in children with community-acquired pneumonia and to provide the evidence for rational use of antimicrobial in clinical diagnosis. Method 570 sputum samples of children with community-acquired pneumonia were collected and cultured for aerobic bacteria and antibiotic susceptibility testing were followed. Results 224 bacterial strains are inspected from 570 children with community-acquired pneumonia. The detection rate is 39.3%, among which gram-positive is 28.2% and gram-negative is 71.8%. The main pathogenic bacteria were klebasiella pneumoniae(47 strains), escherichia coli(25 strains), klebsiella oxytoca(18 strains), staphylococcus epidermidis(18 strains), staphylococcus intermedius(14 strains)and staphylococcus aureus (12 strains). The detection rates of extended spctrum beta-lactamases producing salmonella(ESBLs)is 59.6% in klebasiella pneumoniae(28/47), 64% in Escherichia coli(16/25)and 55.6% in Klebsiella oxytoca (10/18). The methicillin-resistant staphylococcus aureus(MRSA)is 0%(0/12)and the methicillin resistant coagulase negative staphylococcus(MRCON)is 52.9%(27/51). The top three gram negative bacteria are highly sensitive to piperacillin tazobactam, cefoperazone/sulbactam and amikacin.Their drug resistance rate to ampicillin is 100%, to cephalosporin(except cefoxitin)and aztreonam are almost more than 50%. Staphylococcus aureus are drug-resistant to penicillin.The drug resistance of staphylococcus epidermidis is signiifcantly higher than that of staphylococcus aureus. Conclusions The pathogenic bacteria in children with community-acquired pneumonia is mainly gram negative bacteria. The main pathogenic bacteria have strong drug resistance. It is beneifcial for the guide of rational drug use in clinical diagnosis and the management of multiple drug-resistant bacteria to strengthen the monitoring and analysis of bacteria.
