临沂地区小儿下呼吸道感染病原菌季节性分布特点及药敏分析

摘要

Objective To understand seasonal distribution features and drug sensitivity of children lower respiratory tract infection pathogens in Linyi region,in order to provide basis for clinical rational use of antibiotics.Methods 1559 cases of sputum samples from Department of Pediatrics and Neonatology in Maternal and Children Health Hospital of Linyi City were tested for pathogen identification and drug sensitivity from June 2011 to May 2012.Results The total of 677 strains of pathogens were isolated.There were seasonal differences in constituent ratio of common pathogens.The number of pathogens markedly increased in winter but decreased in summer.The Gram-negative bacteria were main strains in fall,but there was no significant difference distribution in spring.The isolated Gram-negative bacteria were mainly Escherichia coli and Klebsiella pneumonia; they had higher resistance to Ampicillin and varying degrees of resistance to Cephalosporin,but high sensitivity to Amikacin,Piperacillin/Tazobactam and Imipenem.While,the isolated Gram-positive bacteria were mainly Staphylococcus Aureus and Streptococcus pneumonia,they had higher resistance to Erythromycin and Penicillin,but the lowest resistance to Vancomycin.Conclusion There are seasonal differences in the common pathogens distribution of lower respiratory tract infection in children,the antibiotics should be rationally used based on susceptibility testing results.%目的 了解临沂地区小儿下呼吸道感染病原菌的季节性分布特点及耐药情况,为临床合理应用抗生素提供依据.方法 对2011年6月～2012年5月山东省临沂市妇幼保健院儿科及新生儿科送检的1559例患儿痰标本进行病原菌鉴定及药物敏感试验.结果 共分离病原菌677株,常见病原菌的构成比有季节性差异,冬季分离病原菌的数量较多,夏季较少,秋季主要以革兰阴性菌为主,春季各分离菌种数量间无明显差异.所检出的革兰阴性菌主要以大肠埃希菌和肺炎克雷伯菌为主,它们对氨苄西林有较高耐药性,对头孢类抗菌药物也有不同程度的耐药性,对阿米卡星、哌拉西林/他唑巴坦和亚胺培南具有较高的敏感性.所检出的革兰阳性菌主要以金黄色葡萄球菌和肺炎链球菌为主,它们对红霉素和青霉素具有较高耐药性,对万古霉素的耐药性最低.结论 小儿下呼吸道感染常见病原菌的分布存在季节性差异,临床应根据药敏试验结果合理应用抗生素.