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目的了解婴儿肺炎病原学分布,为临床经验性用药提供参考。方法对2011年10月-2012年9月在长沙市第一医院儿科住院临床诊断为婴儿肺炎的356例患儿,采集鼻咽部分泌物,进行痰细菌培养及直接免疫荧光法检测呼吸道病毒,分析病原学分布情况及细菌耐药性。结果 356例患儿188例检出病毒阳性或痰细菌培养阳性,病原检出率52.8%,其中呼吸道病毒及痰细菌培养检出率分别为34.8%、42.1%。痰细菌培养以肺炎克雷伯菌(28.1%)最常见,混合感染率高达24.2%;超广谱β-内酰胺酶(ESBLs+)及耐青霉素肺炎链球菌(PRSP)菌检出率较高,分别达68.3%、90.0%,细菌的耐药性较强。病毒感染以冬季好发,以呼吸道合胞病毒(RSV)(57.8%)及副流感病毒3(PIV3)(17.2%)为主。结论婴儿肺炎患儿应及时进行病原学检查,以便临床医师根据其结果合理用药。
Objective To understand the distribution of infant pneumonia etiology and provide reference for clinical experience. Methods A total of 356 children with pneumonia were clinically diagnosed as pneumonia in pediatric hospital of Changsha First Hospital from October 2011 to September 2012. Nasopharyngeal secretions were collected for sputum bacterial culture and direct immunofluorescence to detect respiratory viruses. Analyze the distribution of etiology and bacterial resistance. Results A total of 188 cases of virus positive or sputum were detected in 356 cases. The positive rate of detection was 52.8%. The detection rates of respiratory virus and sputum were 34.8% and 42.1% respectively. Klebsiella pneumoniae (28.1%) was the most common sputum bacterial culture, with a mixed infection rate of 24.2%. The detection rates of ESBLs + and penicillin-resistant Streptococcus pneumoniae (PRSP) Respectively, 68.3%, 90.0%, bacterial resistance is strong. The viral infection was predominant in winter and was mainly respiratory syncytial virus (RSV) (57.8%) and parainfluenza virus 3 (PIV3) (17.2%). Conclusion Infants with pneumonia should be timely etiological examination, so that clinicians based on the results of rational use of drugs.