CAJ | 학술논문

目的：了解儿童下呼吸道感染致病菌的流行趋势和药物敏感性，为临床合理用药提供依据。方法分别对2013年南京医科大学附属南京儿童医院（简称儿童医院）收治的患儿痰培养标本和南京市脑科医院（简称脑科医院）收治的患者痰培养标本进行病原菌培养以及药敏试验，并进行对比性分析。结果2013年入住儿童医院的患儿下呼吸道痰标本中分离出病原菌6124株，其中革兰阴性菌5121株，占62．7％，其分布较多的是流感嗜血杆菌、肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌；革兰阳性菌2734株，占33．5％，以肺炎链球菌和金黄色葡萄球菌为主；真菌311株，占3．8％，以白色假丝酵母菌为主。2013年入住脑科医院的患者下呼吸道痰标本中分离出病原菌1600株，其中革兰阴性菌1134株，占70．9％，其分布较多的是肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌；革兰阳性菌296株，占18．5％，以金黄色葡萄球菌为主；真菌170株，占10．6％，以白色假丝酵母菌为主。对革兰阴性菌敏感的药物有哌拉西林／他唑巴坦和亚胺培南，对革兰阳性菌敏感的药物有利奈唑胺和万古霉素。结论小儿下呼吸道感染病原菌以革兰阴性菌为主，加强细菌培养和耐药性监测对临床合理使用抗菌药物十分必要。
목적：료해인동하호흡도감염치병균적류행추세화약물민감성，위림상합리용약제공의거。방법분별대2013년남경의과대학부속남경인동의원（간칭인동의원）수치적환인담배양표본화남경시뇌과의원（간칭뇌과의원）수치적환자담배양표본진행병원균배양이급약민시험，병진행대비성분석。결과2013년입주인동의원적환인하호흡도담표본중분리출병원균6124주，기중혁란음성균5121주，점62．7％，기분포교다적시류감기혈간균、폐염극뢰백균、대장애희균、포만불동간균、동록가단포균；혁란양성균2734주，점33．5％，이폐염련구균화금황색포도구균위주；진균311주，점3．8％，이백색가사효모균위주。2013년입주뇌과의원적환자하호흡도담표본중분리출병원균1600주，기중혁란음성균1134주，점70．9％，기분포교다적시폐염극뢰백균、대장애희균、동록가단포균、포만불동간균；혁란양성균296주，점18．5％，이금황색포도구균위주；진균170주，점10．6％，이백색가사효모균위주。대혁란음성균민감적약물유고랍서림／타서파탄화아알배남，대혁란양성균민감적약물유리내서알화만고매소。결론소인하호흡도감염병원균이혁란음성균위주，가강세균배양화내약성감측대림상합리사용항균약물십분필요。
Objective To understand the epidemic trend and drug susceptibility of pathogenic bacteria in children with lower re-spiratory tract infection to provide the basis for clinical rational drug use.Methods The sputum culture specimens in these two hospitals during 2013 were performed the pathogenic bacterial culture and the drug susceptibility test respectively.The results were conducted the comparative analysis.Results 6124 strains of bacteria were isolated from the children lower respiratory tract sputum specimens in our hospital during 2013,including 5 121 strains of Gram negative bacteria,accounting for 62.7%,which were domina-ted by Haemophilus influenzae,Klebsiella pneumoniae,Escherichia coli,Bauman Acinetobacter and Pseudomonas aeruginosa;Gram positive bacteria were 2734 strains,accounting for 33.5%,the top two were Streptococcus pneumoniae and Staphylococcus aureus;311 strains of fungi,accounting for 3.8%,and Candida albicans was predominant.1600 strains of bacteria were isolated from the lower respiratory tract sputum specimens in Nanjing Brain Hospital during 2013,including 1 134 strains of Gram negative bacteria, accounting for 70.9%,which were dominated by Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa and Acinetobact-er Bauman;296 strains of Gram positive bacteria,accounting for 18.5%,Staphylococcus aureus was predominant;170 strains of fungi,accounting for 10.6%,Candida albicans was predominant.The sensitive drugs to Gram-negative bacilli were piperacillin /tazobactam and imipenem,while the sensitive drugs to Gram-positive bacilli were linezolid and vancomycin.Conclusion The Gram negative bacteria are the main pathogens of lower respiratory infection in children,and strengthening bacterial culture and drug re-sistance monitoring is necessary for rational use of antibacterial drugs.