苏州地区肺炎患儿咽部吸出物细菌构成比及其耐药性分析

摘要

目的：了解苏州地区住院肺炎患儿咽部常见定植菌情况并分析其耐药性。方法对2005年10月-2011年9月苏州地区因肺炎住院患儿8179例，采用无菌负压吸引法采集新鲜痰液标本进行细菌培养，对检出细菌用纸片扩散法（K-B法）和肉汤稀释法分析其对抗生素的耐药性。结果8179例患儿中细菌检测阳性2391例，阳性率为29.23%。共检出细菌2552株，检出率前五位依次是肺炎链球菌（42.40%）、流感嗜血杆菌（14.81%）、卡他莫拉菌（11.01%）、金黄色葡萄球菌（8.50%）、大肠埃希菌（5.02%）。不同年龄、季节、类型肺炎患儿的咽部常见定植菌的差异有统计学意义（P均<0.001）。2140株细菌进行药敏试验，各细菌耐药率均呈上升趋势。结论苏州地区肺炎患儿最常见的咽部定植菌是肺炎链球菌和流感嗜血杆菌，细菌分布与年龄、季节及肺炎类型有关，需监测细菌并合理用药，以减少耐药菌株的产生。[临床儿科杂志,2013,31(11)：1029-1033]%Objectives To investigate the bacterial pathogens and their antibiotic resistance in children with pneumonia in Suzhou area. Methods Sputum specimens of 8179 hospitalized children with pneumonia from October 2005 to September 2011 were collected by sterile negative pressure aspirator and then cultured. The incidence of positive bacteria was tested by Kirby-Bauer method and broth dilution method, and their antibiotics resistances were analyzed. Results A total of 2391 of 8179 children were infected with positive rate of 29.23%. A total of 2552 strains of bacteria were detected with Streptococcus pneumoniae (42.40%), Haemophilus inlfuenzae (14.81%), Moraxelle catarrhalis (11.01%), Staphylococcus aureus (8.50%) and Escherichia coli (5.02%) as the most common strains. The infection rate of different bacterium was related to age, season and the type of pneumonia (all P<0.001). The tendency of antibiotic resistances in 2 140 bacterial isolates was found increased by the susceptibility test. Conclusions Streptococcus pneumonia and Haemophilus inlfuenzae are the most common bacterial pathogens in children with pneumonia in Suzhou area. The positive rate of different bacterium was related to age, season and the type of pneumonia. Attention must be paid to the rational use of antibiotics to reduce drug resistance.