CAJ | 학술논문

目的：了解三亚地区儿童社区获得性肺炎病原菌分布情况及耐药特点，为临床合理使用抗菌药物提供依据。方法回顾分析三亚地区2011年1月至2013年12月确诊的儿童社区获得性肺炎住院患儿阳性痰培养标本485例。结果485株病原菌中，革兰阴性菌占65．36％，革兰阳性菌占29．28％，真菌占5．36％。排名前五位的细菌是肺炎克雷伯菌、金黄色葡萄球菌、鲍曼不动杆菌、大肠埃希菌、肺炎链球菌。革兰阴性菌对阿米卡星、哌拉西林／他唑巴坦、左氧氟沙星、碳青霉烯类抗菌药物的耐药率均小于20．0％。未发现对万古霉素和利奈唑胺耐药的阳性球菌。结论三亚地区儿童社区获得性肺炎病原菌以革兰阴性菌为主，耐药现象与文献报道存在一定差异，因此临床医生应参照本地区流行病学特点合理使用抗菌药物，以控制细菌耐药率的上升。
목적：료해삼아지구인동사구획득성폐염병원균분포정황급내약특점，위림상합리사용항균약물제공의거。방법회고분석삼아지구2011년1월지2013년12월학진적인동사구획득성폐염주원환인양성담배양표본485례。결과485주병원균중，혁란음성균점65．36％，혁란양성균점29．28％，진균점5．36％。배명전오위적세균시폐염극뢰백균、금황색포도구균、포만불동간균、대장애희균、폐염련구균。혁란음성균대아미잡성、고랍서림／타서파탄、좌양불사성、탄청매희류항균약물적내약솔균소우20．0％。미발현대만고매소화리내서알내약적양성구균。결론삼아지구인동사구획득성폐염병원균이혁란음성균위주，내약현상여문헌보도존재일정차이，인차림상의생응삼조본지구류행병학특점합리사용항균약물，이공제세균내약솔적상승。
Objective To analyze the pathogenic bacteria distribution of pediatric community acquired pneumo‐nia and bacteria resistance in Sanya ,so as to provide a basis for rational use of antibiotics .Methods A total of 485 patients confirmed with community acquired pneumonia were enrolled in this study .The sputum culture results and drug susceptibility test were analyzed .Results In all 485 bacterial isolates ,gram negative bacterium strains accoun‐ted for 65 .36% ,gram positive bacterium strains accounted for 29 .28% ,and fungi were accounted for 5 .36% .Kleb‐siella pneumoniae ,Staphylococcus aureus ,Acinetobacter baumanii ,Escherichia coli and Streptococcus pneumoniae were the most common isolates .Less than 20% gram negative bacterium strains were resistant to amikacin ,piperacil‐lin /tazobactam ,levofloxacin and carbapenem .No vancomycin and linezolid resistant gram positive bacterium strains were found .Conclusion Gram negative bacterium strains were the most common pathogenic bacteria of pediatric community acquired pneumonia in Sanya city ,which differ from other reports .Clinicians should rationally use antimicrobial drugs refering to the epidemiological features of this area ,in order to control the rise of bacterial resistance rate .