中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2014年
23期
115-118
,共4页
儿童%急性下呼吸道感染%病原菌%耐药性
兒童%急性下呼吸道感染%病原菌%耐藥性
인동%급성하호흡도감염%병원균%내약성
Children%Acute lower respiratory tract infection%Pathogenic bacteria%Drug resistance
目的：探讨儿童急性下呼吸道感染病原菌分布及耐药性状况，为临床合理抗感染治疗提供依据。方法：对2011-2013年1622例儿科下呼吸道感染的住院患儿的痰标本进行菌株分离培养和药敏试验，统计分析病原菌及耐药性变化。结果：1622例送检标本检出致病菌659株，阳性率40.6%；革兰阴性杆菌420株，占63.7%；革兰阳性球菌203株，占30.8%；产超广谱β-内酰胺酶的肺炎克雷伯菌呈显著增多趋势；前6位的病原菌依次为肺炎克雷伯菌、大肠埃希菌、肺炎链球菌、金黄色葡萄球菌、铜绿假单胞菌、鲍曼不动杆菌。主要致病菌呈多重耐药性；对金黄色葡萄球菌敏感率较高的抗菌药物有万古霉素、利福平、磺胺类、阿莫西林/克拉维酸等；对肺炎链球菌敏感率较高的抗菌药物有万古霉素、庆大霉素、氯霉素、青霉素、头孢唑啉等；对主要革兰阴性杆菌敏感率由高到低依次为美罗培南、亚胺培南、加酶抑制剂抗菌药物、阿米卡星、头孢他啶、氨苄西林等。结论：革兰阴性杆菌是儿童急性下呼吸道感染的主要致病菌，主要致病菌呈多重耐药性，应根据药敏结果选用抗菌药物进行规范化抗感染治疗，合理使用抗菌药物，减少耐药性的产生。
目的：探討兒童急性下呼吸道感染病原菌分佈及耐藥性狀況，為臨床閤理抗感染治療提供依據。方法：對2011-2013年1622例兒科下呼吸道感染的住院患兒的痰標本進行菌株分離培養和藥敏試驗，統計分析病原菌及耐藥性變化。結果：1622例送檢標本檢齣緻病菌659株，暘性率40.6%；革蘭陰性桿菌420株，佔63.7%；革蘭暘性毬菌203株，佔30.8%；產超廣譜β-內酰胺酶的肺炎剋雷伯菌呈顯著增多趨勢；前6位的病原菌依次為肺炎剋雷伯菌、大腸埃希菌、肺炎鏈毬菌、金黃色葡萄毬菌、銅綠假單胞菌、鮑曼不動桿菌。主要緻病菌呈多重耐藥性；對金黃色葡萄毬菌敏感率較高的抗菌藥物有萬古黴素、利福平、磺胺類、阿莫西林/剋拉維痠等；對肺炎鏈毬菌敏感率較高的抗菌藥物有萬古黴素、慶大黴素、氯黴素、青黴素、頭孢唑啉等；對主要革蘭陰性桿菌敏感率由高到低依次為美囉培南、亞胺培南、加酶抑製劑抗菌藥物、阿米卡星、頭孢他啶、氨芐西林等。結論：革蘭陰性桿菌是兒童急性下呼吸道感染的主要緻病菌，主要緻病菌呈多重耐藥性，應根據藥敏結果選用抗菌藥物進行規範化抗感染治療，閤理使用抗菌藥物，減少耐藥性的產生。
목적：탐토인동급성하호흡도감염병원균분포급내약성상황，위림상합리항감염치료제공의거。방법：대2011-2013년1622례인과하호흡도감염적주원환인적담표본진행균주분리배양화약민시험，통계분석병원균급내약성변화。결과：1622례송검표본검출치병균659주，양성솔40.6%；혁란음성간균420주，점63.7%；혁란양성구균203주，점30.8%；산초엄보β-내선알매적폐염극뢰백균정현저증다추세；전6위적병원균의차위폐염극뢰백균、대장애희균、폐염련구균、금황색포도구균、동록가단포균、포만불동간균。주요치병균정다중내약성；대금황색포도구균민감솔교고적항균약물유만고매소、리복평、광알류、아막서림/극랍유산등；대폐염련구균민감솔교고적항균약물유만고매소、경대매소、록매소、청매소、두포서람등；대주요혁란음성간균민감솔유고도저의차위미라배남、아알배남、가매억제제항균약물、아미잡성、두포타정、안변서림등。결론：혁란음성간균시인동급성하호흡도감염적주요치병균，주요치병균정다중내약성，응근거약민결과선용항균약물진행규범화항감염치료，합리사용항균약물，감소내약성적산생。
To investigate the distribution and drug resistance of pathogenic bacteria in child patients with acute lower respiratory tract infection,to provide evidence for clinical anti infection treatment.Method:1622 sputum samples of child patients with acute lower respiratory tract infection from 2011 to 2013 were tested bacteria and drug sensitivity,the changes of pathogenic bacteria and drug resistance were analyzed statistically.Result:In 1622 specimens,659 strains pathogenic bacteria were isolated,the positive rate was 40.6%.420 strains were gram negative bacilli,accounted for 63.7%.203 strains were gram positive cocci,accounted for 30.8%.Klebsiella pneumoniae producing extended-spectrum β-lactamases were significant increasing trend.The top six pathogens were klebsiella pneumonia,escherichia coli,streptococcus pneumoniae,staphylococcus aureus,pseudomonas aeruginosa and bauman acinetobacter.The main antimicrobial susceptibility for staphylococcus aureus were vancomycin,rifampin, sulfonamides and amoxicillin/clavulanic,etc.The main antimicrobial susceptibility for streptococcus pneumoniae were vancomycin,gentamicin,chloramphenicol,ampicillin and cefazolin,etc.The main antimicrobial susceptibility for gram negative bacilli were meropenem,imipenem,the enzyme inhibitor drug,amikacin,ceftazidime and ampicillin,etc. Conclusion:Gram negative bacilli are the main pathogenic bacteria in child patients with acute lower respiratory tract infection.The main pathogens are multi drug resistance.Antimicrobial drugs should be used to standardize anti-infective therapy based on susceptibility results.Rational use of antimicrobial agents and reduce drug resistance.
