论文部分内容阅读
目的探讨小儿细菌性肺炎细菌病原学特点及药敏情况,指导临床医生的诊治。方法选取2011年1月-2014年12月在该院住院的小儿细菌性肺炎患儿2 160例为研究对象,在抗生素使用前采集标本,对其细菌病原学及药物敏感检测结果进行分析。结果 2011-2014年位于前5位的致病菌为大肠埃希氏菌,金黄色葡萄球菌,肺炎克雷伯菌,卡他莫拉菌,凝固酶阴性葡萄球菌。变化趋势:大肠埃希氏菌和凝固酶阴性葡萄球菌无明显变化(P>0.05),金黄色葡萄球菌明显减少(P<0.01),肺炎克雷伯菌与卡他莫拉菌明显增加(P<0.05)。在G-菌中,大肠埃希氏菌、肺炎克雷伯菌、卡他莫拉菌对氨苄青霉素普遍耐药,前者对头孢类药物(头孢唑啉,头孢他啶、头孢哌酮)耐药率明显增加(P<0.05),肺炎克雷伯菌对头孢唑林的耐药率明显增加(P<0.05),卡他莫拉菌对各药物的耐药率变化不大。在G+菌中,金黄色葡萄球菌和凝固酶阴性葡萄球菌对苯唑西林、头孢曲松等均较敏感,对万古霉素、利奈唑胺最敏感,金黄色葡萄球菌对头孢唑啉的耐药率明显增加(P<0.05),凝固酶阴性葡萄球菌对红霉素耐药率明显增加(P<0.05)。结论该院小儿细菌性肺炎致病菌以大肠埃希氏菌、金黄色葡萄球菌、肺炎克雷伯菌、卡他莫拉菌和凝固酶阴性葡萄球菌5种为最多见,各细菌存在不同程度耐药性增加的情况,尤以G-菌为主。因此临床上要根据细菌耐药情况的变迁合理使用抗生素,增加其有效性,同时减少细菌耐药性的发生。
Objective To investigate the bacterial etiological characteristics and drug susceptibility of bacterial pneumonia in children and guide clinicians in their diagnosis and treatment. Methods A total of 2 160 children with bacterial pneumonia admitted to our hospital from January 2011 to December 2014 were enrolled in this study. Specimens were collected before antibiotics were used to analyze their bacterial etiology and drug susceptibility. Results The top five pathogens from 2011 to 2014 were Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Moraxella catarrhalis, and coagulase-negative staphylococci. (P> 0.05), Staphylococcus aureus (P <0.01), Klebsiella pneumoniae and Moraxella catarrhalis significantly increased (P> <0.05). In G-bacteria, Escherichia coli, Klebsiella pneumoniae and Moraxella catarrhalis were generally resistant to ampicillin. The former showed a significant resistance rate to cephalosporins (cefazolin, ceftazidime and cefoperazone) (P <0.05). The resistant rate of Klebsiella pneumoniae to cefazolin increased significantly (P <0.05), and the resistance rates of Moraxella catarrhalis to each drug did not change much. In G + bacteria, Staphylococcus aureus and coagulase-negative Staphylococcus were more sensitive to oxacillin and ceftriaxone, the most sensitive to vancomycin and linezolid, the resistant to cefazolin in Staphylococcus aureus (P <0.05). The rate of resistance to erythromycin in coagulase-negative staphylococci significantly increased (P <0.05). Conclusion The bacterial pathogens of children with bacterial pneumonia in Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Moraxella catarrhalis and coagulase-negative Staphylococcus are the most common, the bacteria exist to varying degrees Drug resistance increased, especially in G-bacteria. Therefore, according to the clinical changes in bacterial resistance to the rational use of antibiotics to increase its effectiveness, while reducing the incidence of bacterial resistance.