中国实用儿科杂志

中国实用儿科杂志

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温州育英儿童医院小儿下呼吸道感染的病原菌及耐药性调查

杨锦红，李向阳，汪锋平   

  1. 温州医学院附属育英儿童医院，浙江温州325027
  • 收稿日期:2006-01-12 修回日期:2006-05-10 出版日期:2006-08-06 发布日期:2006-08-06

Pathogens causing lower respiratory infection of children and their antibiotic resistance in Pediatric Hospital of Wenzhou Medical College.

Yang Jinhong,Li Xiangyang,Wang Fengping,et al.   

  1. Pediatric Hospital,Wenzhou Medical College,Wenzhou 325027,China
  • Received:2006-01-12 Revised:2006-05-10 Online:2006-08-06 Published:2006-08-06

摘要： 目的调查温州育英儿童医院小儿下呼吸道感染的病原菌及其耐药性。 方法对200301—200412温州医学院附属育英儿童医院呼吸病区1763例下呼吸道感染患儿的痰液标本经分离培养，做菌株鉴定和药敏试验。 结果共分离培养出病原菌715株，总阳性率为40.6%。其中革兰阴性菌448株，占62.7%；革兰阳性菌148株，占20.7%；真菌119株，占16.6%。革兰阴性菌以肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌和鲍曼不动杆菌为主。肺炎克雷伯菌和大肠埃希菌产超广谱β内酰胺酶(ESBLs)的百分率分别为49.3%和46.5%，较敏感的抗生素为亚胺培南、丁胺卡那霉素、环丙沙星、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦；除铜绿假单胞菌对复方新诺明的耐药率为100%外，铜绿假单胞菌和鲍曼不动杆菌对各种抗生素的耐药性均较低。革兰阳性菌中以肺炎链球菌和金黄色葡萄球菌为主。肺炎链球菌对青霉素的耐药率达到71.1%，对环丙沙星和万古霉素敏感，耐药率为0。金黄色葡萄球菌中耐甲氧西林金葡菌(MRSA)占18.0%(9/50)，对环丙沙星、左旋氧氟沙星和万古霉素敏感。 结论温州地区小儿下呼吸道感染的病原菌以革兰阴性菌为主，肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、肺炎链球菌、金黄色葡萄球菌为主要病原菌。对抗生素的耐药性较强，临床上应注意对这些菌株的检测，积极防治。

关键词: 下呼吸道感染, 病原菌, 耐药性

Abstract: AbstractObjectiveTo investigate the pathogen and antibiotic resistance in the lower respiratory infection of children. MethodsBacteria were isolated and identified,antibiotic resistance was detected. ResultsIn 1763 cases,715 strains were obtained from lower respiratory tract sputum samples of children,gramnegative bacterium in 448 strains,being 40.6%;grampositive bacterium in 148 strains,being 20.7%;fungus in 119 strains,being 16.6%.K.pneumoniae,E.coli,Ps.aeruginosa and A.baumanii were gramnegative bacterium’s primary pathogen.The ratio of ESBLs K.pneumoniae and E.coli was 49.3% and 46.5%，respectively.The better antibiotics for them were imipenem，amikacin,ciprofloxacin，piperacillintazobactam，and cefoperazonesulbactam.Antibiotics resistance of Ps.aeruginosa and A.baumanii were low for all antibiotics except for trimethoprimsulfamethoxazole.S.pneumoniae and S.aureus is grampositive bacterium's primary pathogen.Analysis on antibiotics resistance of S.pneumoniae can be discovered that penicillin was 71.1%,ciprofloxacin and vancomycin were 0.MRSA ratio of S.aureus was 18.0%,the better antibiotics for it were ciprofloxacin，levofloxacin and vancomycin. ConclusionGramnegative bacterum is the primary pathogen causing lower respiratory infections of children,K.pneumoniae,E.coli,Ps.aeruginosa,A.baumanii,S.pneumoniae and S.aureus are their primary pathogen； the antibiotics resistance increases evidently.We must notice antibiotics resistance of those bacterium,and take some measures against them.

Key words: Pathogen, Antibiotic resistance