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目的:探讨儿童先天性心脏病(先心病)合并下呼吸道感染痰培养阳性率、病原菌分布和药敏试验结果,为临床防治感染提供选药依据。方法:回顾性分析该院儿科收治的106例先心病合并下呼吸道感染患儿的痰培养和药敏试验报告。结果:痰培养阳性77例,阳性率72.64%,阳性率高。检出菌种19种,G-菌11种,G+菌7种,霉菌1种。痰培养阳性样本以G-菌为主,占57.89%;病原菌种类多,交叉耐药多,敏感药物选择面窄,耐药菌株多;在药物敏感度上有明显优势的药物相对较少。结论:先心病合并下呼吸道感染的痰培养以G-菌为主,应选择对G-菌敏感的抗生素为主,并应酌情辅用对G+菌敏感的联合治疗方案;因儿童年龄及生理特点,临床用药限制多,耐药菌株多,儿童临床药物选择面较成人更窄,采用痰培养结果指导临床合理用药非常必要。
Objective: To investigate the positive rate of sputum culture, the distribution of pathogens and drug susceptibility test results of children with congenital heart disease (congenital heart disease) complicated with lower respiratory tract infection, and to provide the basis of drug selection for clinical prevention and treatment of infection. Methods: A retrospective analysis of pediatric patients admitted to the hospital 106 cases of congenital heart disease in children with sputum culture and drug sensitivity test report. Results: Sputum culture positive 77 cases, the positive rate of 72.64%, the positive rate. Nineteen strains were detected, 11 G-bacteria, 7 G-bacteria and 1 mold. The positive samples of sputum culture were mainly G- bacteria, accounting for 57.89%. There were many kinds of pathogens, many cross-resistances, narrow selection of sensitive drugs and many drug-resistant strains. Drugs with obvious advantages in drug sensitivity were relatively few. Conclusions: G-bacteria are the main pathogens of sputum in congenital heart disease complicated with lower respiratory tract infection. Antibiotics that are sensitive to G-bacteria should be the main choice, and should be supplemented with G + -sensitive combination therapy as appropriate. Because of their age and physiological characteristics , Clinical drug restrictions and more drug-resistant strains, clinical choices of children more narrow than adults, the use of sputum culture results to guide clinical rational use of drugs is necessary.