目的:了解儿童社区获得性肺炎(CAP)的病原菌分布特征及耐药性的变化趋势。方法:对某医院2013-2015年儿科CAP患者呼吸道分离的病原菌进行鉴定及药敏试验,根据美国临床实验室标准化协会(CLSI)2014年版标准判读结果,采用WHONET 5.6软件统计数据。结果:引起儿童CAP感染的主要病原菌为肺炎链球菌、流感嗜血杆菌、卡他莫拉菌、金黄色葡萄球菌及大肠埃希菌,且前3种细菌占各年分离的病原菌构成比逐年增加;肺炎链球菌对青霉素耐药率低于10%,流感嗜血杆菌及卡他莫拉菌产β-内酰胺酶的比例较高,对第三代头孢菌素及美罗培南的耐药率较低。甲氧西林耐药金黄色葡萄球菌(MRSA)的检出率逐年增高,但未发现对万古霉素及利奈唑胺耐药的菌株出现。大肠埃希菌及肺炎克雷伯菌对碳青霉烯耐药率仍较低,但耐药率呈现逐年增高的趋势。结论:儿童CAP感染的病原菌种类与成人不同,病原菌耐药性不容乐观,根据病原菌耐药情况给予经验性抗菌药治疗对于改善CAP患儿的预后具有重要意义。 Objective: To understand the distribution characteristics and drug resistance of pathogenic bacteria in children with community-acquired pneumonia (CAP). Methods: The pathogenic bacteria isolated from respiratory tract of patients with CAP in pediatric hospital from 2013 to 2015 were identified and susceptible to the disease. According to CLSI 2014 edition, the data of WHONET 5.6 software were used. Results: The main pathogenic bacteria causing CAP infection in children were Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus and Escherichia coli, and the proportions of pathogenic bacteria in the first three kinds of bacteria increased year by year ; Streptococcus pneumoniae penicillin resistance rate of less than 10%, Haemophilus influenzae and catarrhal Mola to produce a higher proportion of β-lactamase, third-generation cephalosporins and meropenem resistance rate low. The detection rate of methicillin-resistant Staphylococcus aureus (MRSA) increased year by year, but no strains resistant to vancomycin and linezolid were found. Escherichia coli and Klebsiella pneumoniae carbapenem resistance rate is still low, but the drug resistance showed a trend of increasing year by year. Conclusion: The pathogens of CAP infection in children are different from adults, and the pathogenic bacteria resistance is not optimistic. It is of great significance to improve the prognosis of children with CAP according to the drug resistance of pathogens.