目的：探讨小儿下呼吸道感染病原菌的分布及其对常用抗菌药物的耐药性，为临床应用抗菌药物提供参考。方法选择2011年1月至2013年12月我院儿科收治的下呼吸道感染患儿921例，对其痰标本分离病原菌进行培养鉴定，并采用药敏试验K-B纸片法进行药敏试验。结果921例下呼吸道感染患儿送检痰标本中共检出病原菌629株，检出率为68.3%；其中革兰阴性菌422株，占67.1%；革兰阳性菌168株，占26.7%；真菌39株，占6.2%。主要革兰阴性菌对美罗培南、阿米卡星耐药率较低，对氨苄西林、头孢唑林的耐药率较高；主要革兰阳性菌对万古霉素、呋喃妥因、利福平的耐药率较低，对青霉素G、四环素、红霉素的耐药率很高。结论小儿下呼吸道感染的病原菌主要以革兰阴性菌为主，尤其以大肠埃希菌、铜绿假单胞菌和肺炎克雷伯菌常见，临床应按照病原菌药敏结果，合理应用抗菌药物，减少耐药性。%Objective To investigate the distribution of pathogenic bacteria in children with lower respiratory tract and its drug resist-ance to commonly used antimicrobial agents as to provide the basis for clinical application of antibacterial drugs. Methods A total of 921 chil-dren with lower respiratory tract infection in our hospital from January 2011 to December 2013 were included, and their sputum samples were cultured with pathogens isolated and were susceptibility tested using KB method. Results Sputum specimens of 921 children with lower respir-atory tract infection were detected;pathogens had been detected in 629 cases, and the detection rate was 68. 3%;among these pathogens, 422 were with gram-negative bacteria, accounting for 67. 1%;168 with gram-positive bacteria, accounting for 26. 7%;39 with fungi, accounting for 6. 2%. Mainly Gram-negative bacteria had lower resistance rates to meropenem, amikacin, higher resistance rates to ampicillin, cefazolin;mainly Gram-positive bacteria to vancomycin, nitrofurantoin had lower rates of rifampin resistance, while it had high resistance rates to peni-cillin G, tetracycline, erythromycin. Conclusion The pathogens of lower respiratory tract infection in children are mainly dominated by Gram negative bacteria, especially in Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae, which are clinically common;according to the pathogenic bacteria drug sensitive Results, the use of antimicrobial drugs should be rational in reducing drug resistance.
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