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目的:了解新疆图木舒克市维吾尔族、汉族儿童下呼吸道感染病原菌情况、耐药特征以利指导临床合理用药。方法:2014年8月至2015年7月收集我院儿科264个下呼吸道感染病人的咽喉分泌物进行细菌培养。结果:264份标本培养获得菌株53株,总阳性率20.08%,细菌、真菌检出率分别12.5%、7.57%。病原菌检出率与民族、性别无关,但与年龄关系密切,新生儿期阳性率为60.71%。革兰阴性菌以大肠埃希菌为主(6株),铜绿假单胞菌3株,肺炎克雷白菌,志贺菌属,鲍曼不动杆菌各1株,对青霉素类普遍耐药,加β-内酰胺酶抑制剂克拉维酸后耐药性下降。对一代的头孢噻吩耐药性为83%,对三代、四代头孢的耐药性下降为50%。对氨基糖苷类、喹诺酮类普遍敏感。对亚胺培南、美罗培南无耐药性。革兰氏阳性菌以金黄色葡萄球为主(12株),其他葡萄球菌9株,对青霉素、红霉素普遍耐药,分别为91.7%-66.7%;对苯唑西林、复方新诺明耐药率次之;对夫西地酸、左氧氟沙星、替考拉宁高度敏感;尚未发现对呋喃妥因、利福平、万古霉素耐药的菌株。白色念珠菌20株,未发现有耐药性。结论:新生儿、婴儿免疫功能低下,容易受病菌感染,而且病菌耐药性严重,临床医生应加强病原学研究,合理使用抗生素,减少耐药性的产生。
Objective: To understand the pathogenic bacteria of lower respiratory tract infection among Uygur and Han children in Tumkuk, Xinjiang, in order to guide clinical rational drug use. Methods: From August 2014 to July 2015, we collected 264 throat secretions of pediatric patients with lower respiratory tract infection in our hospital for bacterial culture. Results: 53 strains were obtained from 264 samples and the total positive rate was 20.08%. The detection rates of bacteria and fungi were 12.5% and 7.57% respectively. The detection rate of pathogen was not related to ethnicity and gender, but closely related to age. The positive rate of neonatal period was 60.71%. Gram-negative bacteria mainly Escherichia coli (6 strains), Pseudomonas aeruginosa 3 strains, Klebsiella pneumoniae, Shigella, Acinetobacter baumannii a strain of general resistance to penicillins , Plus β-lactamase inhibitor clavulanic acid resistance decreased. The resistance to cefalotin in the first generation was 83%, and the resistance to third and fourth generation cephalosporins was reduced to 50%. Of aminoglycosides, quinolones generally sensitive. Right imipenem, Meropenem no resistance. Gram-positive bacteria mainly Staphylococcus aureus (12 strains), other Staphylococcus 9 strains of penicillin, erythromycin generally resistant, were 91.7% -66.7%; of oxacillin, cotrimoxazole Resistance rate of the second; fusidic acid, levofloxacin, teicoplanin highly sensitive; yet found no nitrofurantoin, rifampicin, vancomycin resistant strains. Candida albicans 20 strains, no drug resistance was found. Conclusions: Neonates and infants are immunocompromised and susceptible to pathogen infection. In addition, pathogenic bacteria are more likely to be drug-resistant. Clinicians should strengthen etiological study, use antibiotics rationally and reduce drug resistance.