315例小儿下呼吸道感染的病原菌分布及耐药情况分析

摘要

Objective:To investigate the distribution of 315 children with pathogens of lower respiratory tract infection and analyse drug resistance.Method:315 children with lower respiratory tract infections in our hospital were collected and taken sputum specimen collection,culture,drug sensitivity test and resistance analyzing.Result:101 pathogens were isolated,including 37 (36.63％) gram-positive cocci,60 (59.41％) gram-negative bacteria,and 4 (3.96％) fungi.Common gram-negative bacilli were isolated 12 extended-spectrum 3-within Thalidomide enzymes (ESBLs) positive strains,including 6 ESBLs positive Escherichia coli,5 ESBLs positive Klebsiella pneumoniae,one ESBLs positive Haemophilus influenzae.Susceptibility test results showed that gram-positive cocci was sensitive to vancomycin,imipenem.Gramnegative bacilli was sensitive to imipenem,sulbactam class,levofloxacin.ESBLs strains were mostly sensitive to imipenem.Conclusion:Clinicians should pay attention to the pathogen detection and drug susceptibility testing for the complexity of children with lower respiratory tract infection pathogens and drug resistance,in order to rationally using of antibiotics,improving efficacy,and reducing the incidence of drug-resistant strains.%目的:探讨315例小儿下呼吸道感染的病原菌分布,并对耐药情况进行分析.方法:对我院315例小儿下呼吸道感染患者进行痰标本采集、培养及药敏试验,分析其耐药性.结果:共分离出病原菌101株,其中革兰阳性球菌37株(36.63％),革兰阴性杆菌60株(59.41％),真菌4株(3.96％).常见革兰阴性杆菌中共分离出12株超广谱β-内酞胺酶(ESBLs)阳性菌株,其中大肠埃希菌ESBLs阳性6株,肺炎克雷伯菌ESBLs阳性5株,流感嗜血杆菌ESBLs阳性1株.药敏试验结果革兰阳性球菌对万古霉素、亚胺培南较敏感,革兰阴性杆菌对亚胺培南、舒巴坦类、左氟沙星较敏感.ESBLs菌株对亚胺培南最敏感.结论:临床医生应重视病原菌检测与药物敏感试验,针对小儿下呼吸道感染病原菌的复杂性及耐药状况,合理选用抗生素,提高疗效,减少耐药菌株的发生.