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目的通过分析不同季节社区获得性肺炎(CAP)患儿痰培养病原菌阳性检测资料600例,了解梧州市儿童CAP病原菌分布和耐药现状,为该市临床诊治儿童CAP合理用药提供依据。方法随机选取2013-2015年600例CAP痰病原菌培养阳性患儿,按照不同季节进行病原菌分布和耐药分析。结果 600例CAP痰培养阳性患儿共分离622株细菌,其中革兰阴性菌313株,占50.32%;革兰阳性菌309株,占49.68%;主要病原菌为肺炎链球菌、大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、流感嗜血杆菌和卡他布兰汉菌等;青霉素不敏感肺炎链球菌为70.95%,未发现金黄色葡萄球菌对万古霉素具有耐药性;大肠埃希菌、肺炎克雷伯菌对常用抗生素耐药率较高,未发现对亚胺培南、美罗培南耐药。肺炎链球菌、流感嗜血杆菌、肺炎克雷伯菌在不同季节分布差异有统计学意义(χ2值分别为18.912、14.374、11.042,P≤0.05)。结论肺炎链球菌、流感嗜血杆菌、肺炎克雷伯菌在不同季节分布有差异,检出病原菌对常用抗生素有不同程度耐药,应根据药敏结果合理使用抗生素。
Objective To analyze the distribution and drug resistance of CAP pathogens in children in community-acquired pneumonia (CAP) in different seasons and to provide basis for clinical diagnosis and treatment of CAP in children. Methods Six hundred children with CAP sputum positive culture were randomly selected from 2013 to 2015. Pathogenic bacteria distribution and drug resistance were analyzed according to different seasons. Results A total of 622 strains of bacteria were isolated from 600 cases of sputum culture positive patients, of which 313 were Gram-negative bacteria, accounting for 50.32%; 309 were Gram-positive bacteria, accounting for 49.68%; the main pathogens were Streptococcus pneumoniae, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Haemophilus influenzae andCathatt bacillus; Penicillin-insensitive Streptococcus pneumoniae was 70.95%, no Staphylococcus aureus was found to be resistant to vancomycin; Escherichia coli, Klebsiella pneumoniae resistant rate of commonly used antibiotics higher, no resistance to imipenem, Meropenem. Streptococcus pneumoniae, Haemophilus influenzae, Klebsiella pneumoniae in different seasons distribution differences were statistically significant (χ2 values were 18.912,14.374,11.042, P≤0.05). Conclusions Streptococcus pneumoniae, Haemophilus influenzae and Klebsiella pneumoniae are different in different seasons. The pathogens detected are resistant to commonly used antibiotics, and antibiotics should be used reasonably according to the susceptibility results.