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目的了解住院儿童患者下呼吸道感染革兰阴性菌种类情况及耐药特点,为指导临床科学选用抗菌药物提供依据。方法采用细菌分离鉴定技术和药敏试验方法,对某大型综合医院住院患儿下呼吸道感染病原菌进行分离鉴定和药敏试验。结果共调查该医院确诊为下呼吸道感染患儿1 219例,从送检的痰液中分离出革兰阴性菌903株,分离率为74.08%。痰液分离的革兰阴性菌中的优势菌主要有肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌和铜绿假单胞菌,构成比依次为39.65%、32.22%、19.16%和9.08%。下呼吸道感染革兰阴性菌对多种抗菌药物普遍耐药,尤其对头孢唑林耐药率最高。结论该医院住院患儿下呼吸道感染病原菌中,革兰阴性菌占主导,且普遍耐药,提示应根据药敏试验结果选择抗菌治疗药物。
Objective To understand the characteristics and drug resistance of Gram-negative bacteria in lower respiratory tract infection in hospitalized children and provide the basis for choosing antibacterial drugs in clinical science. Methods Bacterial isolation and identification techniques and drug susceptibility testing methods were used to isolate and identify pathogenic bacteria of lower respiratory tract infection in hospitalized children in a large general hospital. Results A total of 1 219 cases of lower respiratory tract infection were diagnosed in this hospital. 903 Gram-negative bacteria were isolated from the sputum of the patients, the isolation rate was 74.08%. The predominant bacteria in Gram-negative bacteria isolated from sputum were mainly Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii and Pseudomonas aeruginosa, with the constituent ratios of 39.65%, 32.22%, 19.16% and 9.08%. Gram-negative bacteria in lower respiratory tract infections are generally resistant to various antimicrobial agents, especially cefazolin. Conclusion Among the pathogenic bacteria of lower respiratory tract infection in hospitalized children, Gram-negative bacteria are dominant and are generally resistant to antibiotics, suggesting that antibacterial drugs should be selected according to the results of susceptibility testing.