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目的了解烟台地区儿童急性社区获得性肺炎(CAP)的病原菌分布和细菌耐药情况,以指导临床合理用药。方法无菌操作吸取患儿咽部深处分泌物,采用巧克力培养基、血平板培养基、麦康凯培养基培养,通过ATB法和KB法进行细菌药物敏感试验。结果送检标本722例,阳性标本319例,总阳性率44.2%。319例阳性标本中,革兰阴性菌株156株,占48.9%;革兰阳性菌株163株,占51.1%。前三位病原菌为肺炎链球菌(占39.5%)、流感嗜血杆菌(占26.1%)、金黄色葡萄球菌(占6.9%)。肺炎链球菌对红霉素、四环素、氯霉素、复方新诺明、青霉素耐药率分别高达98.1%、90.9%、86.4%、88.4%及52.3%。结论肺炎链球菌及流感嗜血杆菌是烟台地区儿童CAP的主要致病菌,肺炎链球菌耐药现象严重。对儿童CAP的治疗应根据病原菌培养结果合理选择抗生素。
Objective To understand the distribution of pathogenic bacteria and bacterial resistance in children with acute community-acquired pneumonia (CAP) in Yantai, so as to guide clinical rational drug use. Methods The aseptic operation was used to draw the secretions from the throat of children. The cultures were cultured in chocolate medium, blood plate medium and MacConkey medium. The bacterial drug sensitivity test was carried out by ATB method and KB method. Results 722 specimens were tested, 319 positive specimens, the total positive rate was 44.2%. Among 319 positive samples, 156 strains were Gram-negative, accounting for 48.9%; 163 strains were Gram-positive, accounting for 51.1%. The first three pathogens were Streptococcus pneumoniae (39.5%), Haemophilus influenzae (26.1%) and Staphylococcus aureus (6.9%). Streptococcus pneumoniae to erythromycin, tetracycline, chloramphenicol, cotrimoxazole, penicillin resistance rates as high as 98.1%, 90.9%, 86.4%, 88.4% and 52.3%. Conclusions Streptococcus pneumoniae and Haemophilus influenzae are the main pathogens of CAP in children in Yantai area. Streptococcus pneumoniae resistance is serious. The treatment of children with CAP should be based on the results of pathogen culture reasonable choice of antibiotics.