CAJ | 학술논문

目的：了解顺德地区学龄前儿童急性呼吸道感染（A RI ）鼻咽部细菌分布及耐药状况，以指导临床诊疗。方法选择2013年10月至2014年12月医院住院治疗的学龄前A RI患儿1003例，其中急性上呼吸道感染302例，支气管炎126例，肺炎575例。采集咽拭子，进行菌种鉴定、药敏试验和统计学分析。结果（1）该地区儿童A RI以春季好发；住院患儿肺炎感染占57．3％。（2）1003份咽拭子分离菌株213株，阳性率为21．2％，其中革兰阴性菌和革兰阳性菌分别占53．1％、42．3％，假丝酵母菌占4．2％。（3）患儿鼻咽部病原菌检测的阳性率随着年龄的增长而降低；各年龄组检出菌谱有所差异，但均以金黄色葡萄球菌（S A ）检出为首。（4）S A 100％产β‐内酰胺酶， M RSA占28．8％；产ESBL的大肠埃希菌和肺炎克雷伯菌为15．4％、25．0％。结论监测期间该地区主要流行菌株是SA ；学龄前儿童ARI各年龄段的细菌种类和阳性率不尽相同，临床选择抗菌药物时，应加强监测，综合考虑各种因素。
목적：료해순덕지구학령전인동급성호흡도감염（A RI ）비인부세균분포급내약상황，이지도림상진료。방법선택2013년10월지2014년12월의원주원치료적학령전A RI환인1003례，기중급성상호흡도감염302례，지기관염126례，폐염575례。채집인식자，진행균충감정、약민시험화통계학분석。결과（1）해지구인동A RI이춘계호발；주원환인폐염감염점57．3％。（2）1003빈인식자분리균주213주，양성솔위21．2％，기중혁란음성균화혁란양성균분별점53．1％、42．3％，가사효모균점4．2％。（3）환인비인부병원균검측적양성솔수착년령적증장이강저；각년령조검출균보유소차이，단균이금황색포도구균（S A ）검출위수。（4）S A 100％산β‐내선알매， M RSA점28．8％；산ESBL적대장애희균화폐염극뢰백균위15．4％、25．0％。결론감측기간해지구주요류행균주시SA ；학령전인동ARI각년령단적세균충류화양성솔불진상동，림상선택항균약물시，응가강감측，종합고필각충인소。
Objective To understand the nasopharyngeal pathogenic bacteria distribution and antibiotic resist‐ance situation in the preschool children with acute respiratory infections (ARI) in order to guide clinical diagnosis and treatment .Methods A total of 1 003 pre‐school children inpatients with ARI from Oct .2013 to Dec .2014 were se‐lected ,including of 302 cases of ARI ,126 cases of bronchitis and 575 cases of pneumonia .The nasopharyngeal swab was collected for conducting the pathogenic bacterialidentification and antibiotic susceptibility test .The results were statistically analyzed .Results (1)Children with ARI were used to appear mostly in spring in this area ;children inpa‐tients with pneumonia accounted for 57 .3% .(2)A total of 213 strains of bacteria were isolated from 1 003 pharyngeal swabs ,the positive rate was 21 .2% .The proportions of Gram negative bacilli ,Gram positive cocci and Candida were 53 .1% ,42 .3% and 4 .2% respectively .(3)With the increase of age ,the positive rate of nasopharyngeal pathogen de‐tection was significantly reduced ;the bacterial spectrum detected in various age groups of ARI was different ,and the detection rate of Staphylococcus aureus (SA) was highest .(4) 100% of SA yielded β‐lactamase ,in which MRSA ac‐counted for 28 .8% ;E .coli and K .pneumoniae producing extended spectrum beta‐lactamase(ESBL) were 15 .4% and 25 .0% respectively .Conclusion SA is the most predominant pathogenic strain ;the bacterial species and positive rate in different age groups of pre‐school children ARI are not the same .Selecting antibacterial drugs in clinic should strengthen monitoring and comprehensively consider various factors .