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目的:了解本地区小儿呼吸道感染常见病原菌及其对常用抗菌药的耐药性。为临床药物治疗提供有价值的参考。方法:对2006年7月～2007年7月住院的下呼吸道感染患儿常规进行深部痰培养,并做细菌株鉴定和药敏试验。结果:下呼吸道感染患儿共3527例,共培养出病原菌1056株,阳性率为29.9%,其中G~-菌751株(71.1%),G~+菌207株(19.6%),真菌91株(8.6%)。最常见的病原菌为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、鲍曼不动杆菌。分离率分别为:23.9%,21.6%,8.6%,8.0%,6.0%。肺炎克雷伯菌和大肠埃希菌产超广谱β-内酰胺酶的百分率分别为45.2%、41.7%,较敏感的抗菌药为亚胺培南、环丙沙星、阿米卡星。G~-菌(肺炎克雷伯菌、大肠埃希菌、鲍曼不分杆菌、铜绿假单胞菌)对氨苄西林、头孢唑林显示高耐药性。金黄色葡萄球菌中耐甲氧西林金葡萄占14.3%,金葡萄对氯霉素、万古霉素、利福平敏感。阴沟肠杆菌虽然分离率不高,但存在相当高的耐药率。结论:对下呼吸道感染患儿需及早做细菌学检测,合理选用抗菌药。
Objective: To understand the common pathogenic bacteria of respiratory tract infection in children in this area and its resistance to common antibacterials. Provide valuable reference for clinical drug treatment. Methods: Children with lower respiratory tract infection who were hospitalized from July 2006 to July 2007 were routinely subjected to deep sputum culture and bacterial identification and drug susceptibility testing were performed. Results: A total of 3527 children with lower respiratory tract infection were enrolled. A total of 1056 pathogenic bacteria were co-cultured, the positive rate was 29.9%, of which 751 (71.1%) were G ~ (8.6%). The most common pathogens are Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter baumannii. Separation rates were: 23.9%, 21.6%, 8.6%, 8.0%, 6.0%. Klebsiella pneumoniae and Escherichia coli production of extended-spectrum β-lactamase were 45.2%, 41.7%, the more sensitive antibacterial drugs for imipenem, ciprofloxacin, amikacin. G ~ - bacteria (Klebsiella pneumoniae, Escherichia coli, Bourjoiecobacterium baumannii, Pseudomonas aeruginosa) of ampicillin, cefazolin showed high resistance. Staphylococcus aureus methicillin-resistant gold grape accounted for 14.3%, gold grape on chloramphenicol, vancomycin, rifampicin-sensitive. Enterobacter cloacae, although the isolation rate is not high, but there is a very high resistance rate. Conclusion: Children with lower respiratory tract infection need to make bacteriological tests as early as possible, and rational use of antimicrobial agents.