儿童重症肺炎病原菌分布特点及抗菌药物耐药性调查

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目的统计分析该院住院治疗的重症肺炎患儿所检出的病原菌及耐药性分析结果,以期为更为合理的临床用药提供科学依据。方法统计分析住院治疗的重症肺炎患儿所检出的病原菌及耐药性分析结果,采用法国梅里埃公司的ATB-NEW全自动细菌鉴定仪及药敏分析仪进行细菌鉴定及药敏分析。结果纳入本次研究的262例患儿有97例患儿分离出致病菌,分离率为37.02%,共分离到菌株109株;其中肺炎克雷伯菌占30.28%,大肠埃希菌占16.51%,金黄色葡萄球菌和鲍曼不动杆菌分别占14.68%和10.09%;耐药性分析结果,金黄色葡萄球菌各种药物均有耐药菌株出现,耐药性最高的是亚胺培南,耐药率达到了93.75%,头孢唑林、环丙沙星、哌拉西林则相对敏感;肺炎克雷伯菌最敏感的药物是阿米卡星,头孢噻肟的耐药率最高;大肠埃希菌对头孢噻吩最为敏感,对氨苄西林和头孢西丁耐药率最高;鲍曼不动杆菌对阿米卡星、亚胺培南均全部敏感,对其他药物的耐药性也不高。结论儿童重症肺炎病原菌分布及耐药性,均有一定的特征,应采取针对性的用药措施,以避免耐药性,提高治愈率。 Objective To analyze and analyze the results of pathogenic bacteria and drug resistance in children with severe pneumonia treated in hospital in order to provide a scientific basis for a more reasonable clinical medication. Methods Statistical analysis of pathogenic bacteria and drug resistance in children with severe pneumonia admitted to hospital were carried out. Bacteria identification and drug susceptibility analysis were performed by ATB-NEW automatic bacteria analyzer and drug sensitivity analyzer from Merial France. Results A total of 262 children were included in this study. 97 isolates were isolated and the isolation rate was 37.02%. A total of 109 isolates were isolated, of which Klebsiella pneumoniae accounted for 30.28% and Escherichia coli 16.51 %, Staphylococcus aureus and Acinetobacter baumannii accounted for 14.68% and 10.09%, respectively. The result of drug resistance analysis showed that all the drug-resistant strains of Staphylococcus aureus appeared. The most resistant strains were imipenem , Resistance rate reached 93.75%, cefazolin, ciprofloxacin, piperacillin is relatively sensitive; Klebsiella pneumoniae most sensitive drug is amikacin, cefotaxime resistance rate was the highest; large intestine Escherichia coli is the most sensitive to cefalotin, the highest rate of resistance to ampicillin and cefoxitin; Acinetobacter baumannii amikacin, imipenem are all sensitive to other drug resistance is not high . Conclusion The distribution and drug resistance of pathogenic bacteria in severe pneumonia in children all have certain characteristics. Drug-related measures should be taken to avoid drug resistance and improve the cure rate.
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