CAJ | 학술논문

目的：比较儿童下呼吸道感染痰涂片与痰培养结果，了解痰涂片的实验室诊断价值，同时对痰培养感染病原菌的分布及耐药性进行分析，以指导临床合理用药。方法收集2014年3—5月某院915份下呼吸道感染住院患儿的合格痰标本，涂片后进行革兰染色，同时对痰标本进行细菌培养、鉴定及药敏试验，将革兰染色镜检结果与培养结果进行比较。结果痰涂片与痰培养结果总体符合率为67．43％（617份），痰培养阳性率为65．90％（603份）；分离病原菌730株，其中居前3位者分别是副流感嗜血杆菌（36．17％）、肺炎链球菌（24．38％）、卡他莫拉菌（13．29％）。产β－内酰胺酶率：副流感嗜血杆菌、流感嗜血杆菌、卡他莫拉菌分别为44．70％（118／264）、45．83％（11／24）、93．81％（91／97）。肺炎链球菌对大多数抗菌药物较敏感，对红霉素、四环素、复方磺胺甲口恶唑耐药率高，未发现对万古霉素、利奈唑胺、莫西沙星耐药的菌株。结论痰涂片具有一定的实验室诊断价值，痰培养同时应做涂片革兰染色，临床医生可根据常见病原菌的药敏结果合理用药，减少耐药菌的产生。
목적：비교인동하호흡도감염담도편여담배양결과，료해담도편적실험실진단개치，동시대담배양감염병원균적분포급내약성진행분석，이지도림상합리용약。방법수집2014년3—5월모원915빈하호흡도감염주원환인적합격담표본，도편후진행혁란염색，동시대담표본진행세균배양、감정급약민시험，장혁란염색경검결과여배양결과진행비교。결과담도편여담배양결과총체부합솔위67．43％（617빈），담배양양성솔위65．90％（603빈）；분리병원균730주，기중거전3위자분별시부류감기혈간균（36．17％）、폐염련구균（24．38％）、잡타막랍균（13．29％）。산β－내선알매솔：부류감기혈간균、류감기혈간균、잡타막랍균분별위44．70％（118／264）、45．83％（11／24）、93．81％（91／97）。폐염련구균대대다수항균약물교민감，대홍매소、사배소、복방광알갑구악서내약솔고，미발현대만고매소、리내서알、막서사성내약적균주。결론담도편구유일정적실험실진단개치，담배양동시응주도편혁란염색，림상의생가근거상견병원균적약민결과합리용약，감소내약균적산생。
Objective To compare sputum smear and culture results in children with lower respiratory infection, realize the laboratory diagnostic value of sputum smear,and analyze the distribution and antimicrobial resistance of cultured pathogens in infection,so as to guide rational antimicrobial use in clinic.Methods Qualified sputum speci-mens collected from hospitalized children with lower respiratory tract infection from March to May 2014 were con-ducted gram-staining after smeared,meanwhile,bacterial culture,identification and antimicrobial susceptibility tes-ting of sputum specimens were performed,gram-staining microscopic examination and culture results were com-pared.Results The overall coincidence rate of sputum smear and culture results was 67.43%(n =617),positive rate of sputum culture was 65.90%(n =603);730 pathogenic strains were isolated,the top 3 isolated pathogens were Haemophilus parainfluenzae (36.17%),Streptococcus pneumoniae (24.38%),and Moraxella catarrhalis (13.29%).β-lactamase-producing rates of Haemophilus parainfluenzae ,Haemophilus influenzae ,and Moraxella catarrhalis were 44.70%(118/264),45.83%(11/24),and 93.81 %(91/97)respectively.Streptococcus pneumoniae were susceptible to most antimicrobial agents,while resistant rates to erythromycin,tetracycline,and compound sulfamethoxazole were high, vancomycin-, linezolid-, and/or moxifloxacin-resistant strains were not found. Conclusion Sputum smear has certain laboratory diagnostic value,gram-staining is recommended while sputum cul-ture is performed,antimicrobial agents should be used rationally according to antimicrobial susceptibility testing re-sults,so as to reduce the emergence of antimicrobial-resistant organisms.