CAJ | 학술논문

目的：了解某院小儿急性下呼吸道感染常见病原菌分布、耐药性及变化趋势，为临床合理使用抗菌药物提供依据。方法对某院2011年1月—2013年12月儿科住院患儿下呼吸道感染痰培养分离的非重复病原菌资料进行统计分析。结果分离病原菌934株，其中革兰阴性（G－）菌728株（77．94％），主要为肺炎克雷伯菌（278株）、大肠埃希菌（216株）、阴沟肠杆菌（85株）、铜绿假单胞菌（63株）；革兰阳性（G＋）菌195株（20．87％），主要为金黄色葡萄球菌（132株）、肺炎链球菌（49株）。药敏结果提示，主要 G－菌对亚胺培南、美罗培南、阿米卡星敏感率均为100．00％，对头孢他啶／克拉维酸、哌拉西林／他唑巴坦耐药率相对较低，对头孢菌素类耐药率逐年增高。主要 G＋菌对万古霉素敏感率均为100．00％，对红霉素、克林霉素较耐药。结论该院小儿下呼吸道感染病原菌以 G－菌为主，对常用抗菌药物的耐药率呈逐年上升趋势，应加强儿童抗菌药物使用管理，预防多重耐药菌医院感染发生。
목적：료해모원소인급성하호흡도감염상견병원균분포、내약성급변화추세，위림상합리사용항균약물제공의거。방법대모원2011년1월—2013년12월인과주원환인하호흡도감염담배양분리적비중복병원균자료진행통계분석。결과분리병원균934주，기중혁란음성（G－）균728주（77．94％），주요위폐염극뢰백균（278주）、대장애희균（216주）、음구장간균（85주）、동록가단포균（63주）；혁란양성（G＋）균195주（20．87％），주요위금황색포도구균（132주）、폐염련구균（49주）。약민결과제시，주요 G－균대아알배남、미라배남、아미잡성민감솔균위100．00％，대두포타정／극랍유산、고랍서림／타서파탄내약솔상대교저，대두포균소류내약솔축년증고。주요 G＋균대만고매소민감솔균위100．00％，대홍매소、극림매소교내약。결론해원소인하호흡도감염병원균이 G－균위주，대상용항균약물적내약솔정축년상승추세，응가강인동항균약물사용관리，예방다중내약균의원감염발생。
Objective To realize the distribution and change in antimicrobial resistance of common pathogens causing acute lower respiratory tract infection (LRTI)in children,and provide evidence for rational use of antimicrobial agents. Methods Data about pathogens from children with LRTI in a hospital between January 2011 and December 2013 were ana-lyzed statistically.Results Of 934 isoalted pathogenic strains,728 (77.94%)were gram-negative bacteria,the major were Klebsiella pneumoniae (n =278),Escherichia coli (n =216),Enterobacter cloacae (n =85 ),and Pseudomonas aeruginosa (n=63).The isolation rate of gram-positive bacteria was 20.87%(n=195),the major were Staphylococcus aureus (n=132)and Streptococcus pneumoniae (n=49).Antimicrobial susceptibility testing results revealed that sensitive rate of gram-negative bacteria to imipenem,meropenem,and amikacin were all 100.00%,to ceftazidime/clavulanic acid and piperacillin/tazobactam were relatively low,to cephalosporins increased year by year.Sensitive rates of the main gram-positive bacteria to vancomycin were both 100.00%, to erythromycin and clindamycin were relatively low. Conclusion The major pathogenic bacteria causing LRTI in pediatric department are gram-negative bacteria,antimicrobial resistance rates increased year by year,management of antimicrobial use in children should be strengthened to prevent the occurrence of multidrug-resistant organism infection.