论文部分内容阅读
目的了解复旦大学附属儿科医院2000至2006年呼吸道感染患儿流感嗜血杆菌、肺炎链球菌、化脓性链球菌和卡他莫拉菌的分离率及耐药趋势。方法对29416例呼吸道感染患儿进行4种致病菌分离率及耐药趋势回顾,细菌分离培养采用常规方法,药敏试验采用KB琼脂扩散法。结果化脓性链球菌年分离率为10.7%～25.4%,占咽拭子致病菌首位,呈逐年上升趋势(P=0.01)。流感嗜血杆菌、肺炎链球菌及卡他莫拉菌在下呼吸道感染患儿痰液中年分离率分别为1.7%～8.9%、1.1%～5.9%和0.7%～4.7%,3种致病菌分离率变化不明显(P>0.05),其中流感嗜血杆菌年分离率明显高于卡他莫拉菌(P=0.026)。痰液标本中未分离到化脓性链球菌。流感嗜血杆菌对氨苄西林耐药率为15.0%～30.0%,上升趋势不显著(P=0.4),对头孢克罗耐药率为2.5%～11.2%,增加趋势明显(P=0.005)。青霉素高度耐药肺炎链球菌为4.2%～27.3%,低度耐药株为35.0%～61.2%,两者增加趋势显著(P<0.05)。化脓性链球菌对青霉素仍高度敏感,红霉素耐药率高达85%以上。卡他莫菌β-内酰胺类阳性率在95%左右。结论化脓性链球菌是上呼吸道细菌感染的首要致病菌,分离率呈上升趋势,绝大多数已对红霉素耐药。流感嗜血杆菌、肺炎链球菌和卡他莫拉菌在下呼吸道感染患儿痰液标本中分离率变化不明显,其中流感嗜血杆菌对头孢克罗及肺炎链球菌对青霉素的耐药率呈明显增加趋势。
Objective To investigate the isolation rate and drug resistance of Haemophilus influenzae, Streptococcus pneumoniae, Streptococcus pyogenes and Moraxella catarrhalis in children with respiratory tract infection from 2000 to 2006 in Pediatric Hospital of Fudan University. Methods The isolation rates and drug resistance trends of 4 pathogenic bacteria in 29 416 cases of respiratory tract infection were retrospectively reviewed. Bacteria were separated and cultured by conventional methods. The susceptibility test was performed by KB agar diffusion method. Results The annual isolation rate of Streptococcus pyogenes was 10.7% ~ 25.4%, accounting for the top of throat swab pathogens, showing an upward trend year by year (P = 0.01). Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis in children with lower respiratory tract infection in sputum in the annual isolation rates were 1.7% to 8.9%, 1.1% to 5.9% and 0.7% to 4.7%, three kinds of pathogenic bacteria The separation rate did not change significantly (P> 0.05). The isolation rate of Haemophilus influenzae was significantly higher than that of Moraxella catarrhalis (P = 0.026). Sputum specimens were not isolated Streptococcus pyogenes. The rate of resistance to ampicillin in Haemophilus influenzae was 15.0% ~ 30.0%, and the upward trend was not significant (P = 0.4). The rate of resistance to cefaclor was 2.5% ~ 11.2%. Penicillin highly resistant Streptococcus pneumoniae was 4.2% ~ 27.3%, low resistant strains was 35.0% ~ 61.2%, both increased significantly (P <0.05). Streptococcus pyogenes is still highly sensitive to penicillin, erythromycin resistance rate as high as 85%. Catarrhalia β-lactam positive rate of about 95%. Conclusion Streptococcus pyogenes is the primary pathogen of upper respiratory tract bacterial infection, the isolation rate is on the rise, and the vast majority has been resistant to erythromycin. Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhal sputum specimens of children with lower respiratory tract infection did not change significantly, of which Haemophilus influenzae on cefaclor and Streptococcus pneumoniae penicillin resistance rate was significantly Increase the trend.