摘要
目的:分析重症细菌性肺炎患儿呼吸道标本中病原菌的分布与耐药情况,为该类疾病的治疗提供参考。方法:选取2018年1月—2021年1月河南科技大学第一附属医院收治的436例重症细菌性肺炎患儿作为研究对象,分析患儿呼吸道标本中病原菌的分布与主要病原菌的耐药情况。结果:436例患儿的呼吸道标本中共检出562株病原菌,其中革兰阴性菌294株(占72.06%,以鲍曼不动杆菌、大肠埃希菌、肺炎克雷伯菌为主)、革兰阳性菌114株(占27.94%,以金黄色葡萄球菌、肺炎链球菌为主);药敏结果显示,鲍曼不动杆菌、大肠埃希菌、肺炎克雷伯菌对头孢噻肟、哌拉西林、氨曲南、亚胺培南的耐药率较低(<25.00%),对阿米卡星、头孢唑林、头孢哌酮-舒巴坦钠、妥布霉素、美罗培南的耐药率较高(>60.00%);金黄色葡萄球菌和肺炎链球菌对利奈唑胺、万古霉素的耐药率较低(<10.00%),对红霉素、林可霉素、左氧氟沙星的耐药率较高(>65.00%)。结论:儿童重症细菌性肺炎的主要病原菌为革兰阴性菌,其耐药性较强,临床在治疗时应尽量根据病原菌培养结果及其耐药特点选择合适的抗菌药物,以确保治疗的效果。
Objective:To analyze the distribution and drug resistance of pathogenic bacteria in respiratory specimens of children with severe bacterial pneumonia,and provide reference for the treatment of such diseases.Methods:A total of 436 children with severe bacterial pneumonia admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2018 to January 2021 were selected as study subjects,and the distribution of pathogenic bacteria in respiratory specimens and the drug resistance of main pathogenic bacteria were analyzed.Results:A total of562 strains of pathogenic bacteria were detected in the respiratory specimens of 436 children,including 294 strains of Gram-negative bacteria(72.06%,primarily Acinetobacter baumannii,Escherichia coli and Klebsiella pneumoniae),114 strains of Gram-positive bacteria(27.94%,primarily Staphylococcus aureus and Streptococcus pneumoniae).The results of drug susceptibility test showed that the resistance rates of Acinetobacter baumannii,Escherichia coli and Klebsiella pneumoniae to cefotaxime,piperacillin,aztreonam and imipenem were low(less than 25.00%),and their resistance rates to amikacin,cefazolin,cefoperazone-sulbactam sodium,tobramycin and meropenem were high(greater than 60.00%);the resistance rates of Staphylococcus aureus and Streptococcus pneumoniae to linezolid and vancomycin were low(less than 10.00%),and their resistance rates to erythromycin,lincomycin and levofloxacin were high(greater than 65.00%).Conclusion:The main pathogenic bacteria of severe bacterial pneumonia in children are Gram-negative bacteria which have strong drug resistance.In clinical treatment,appropriate antibacterial drugs should be selected according to the culture results of pathogenic bacteria and their drug resistance characteristics as far as possible to ensure the therapeutic effect.
作者
薛甜甜
屈花便
XUE Tian-tian;QU Hua-bian(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang Henan 471000,China)
出处
《抗感染药学》
2022年第9期1264-1267,共4页
Anti-infection Pharmacy
关键词
重症细菌性肺炎
儿童
病原菌分布
耐药特点
severe bacterial pneumonia
child
distribution of pathogenic bacteria
drug resistance characteristics
