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目的了解福州儿童医院2013—2015年下呼吸道感染患儿的主要病原分布及耐药情况,为临床合理用药提供依据。方法对收治的下呼吸道感染2 468例痰标本,按相关标准进行分离培养、鉴定和药敏试验。结果 2 468份痰标本共分离出致病菌991株(40.2%),其中革兰阳性菌占36.0%,革兰阴性菌占59.9%,真菌占4.0%。常见病原菌:肺炎链球菌17.9%、金黄色葡萄球菌16.3%、肺炎克雷伯菌15.2%、大肠埃希菌14.6%、流感嗜血杆菌7.3%、鲍曼不动杆菌4.7%、铜绿假单胞菌4.1%。药敏试验:金黄色葡萄球菌对青霉素耐药率达94.4%,肺炎链球菌和金黄色葡萄球菌对复方新诺明、红霉素、克林霉素耐药率均≥30%;肺炎克雷伯菌、大肠埃希菌、流感嗜血杆菌、鲍曼不动杆菌对复方新诺明的耐药率30.5%~59.6%;大肠埃希菌和鲍曼不动杆菌对三代头孢类、氨苄西林/舒巴坦的耐药率27.7%~34.0%。结论临床治疗儿童下呼吸道感染应根据病原及药敏结果合理用药,以减少耐药菌株的产生。
Objective To understand the distribution and drug resistance of the major pathogens in children with lower respiratory tract infection in Fuzhou Children’s Hospital from 2013 to 2015, and provide the basis for clinical rational drug use. Methods A total of 2 468 sputum specimens of lower respiratory tract infection were collected and isolated for culture, identification and drug susceptibility testing according to relevant standards. Results A total of 991 strains of bacteria (40.2%) were isolated from 2 468 sputum specimens, of which Gram-positive bacteria accounted for 36.0%, Gram-negative bacteria accounted for 59.9% and fungi accounted for 4.0%. Common pathogens: Streptococcus pneumoniae 17.9%, Staphylococcus aureus 16.3%, Klebsiella pneumoniae 15.2%, Escherichia coli 14.6%, Haemophilus influenzae 7.3%, Acinetobacter baumannii 4.7%, Pseudomonas aeruginosa 4.1% of bacteria. Drug susceptibility test: Staphylococcus aureus resistance rate of 94.4% penicillin, Streptococcus pneumoniae and Staphylococcus aureus cotrimoxazole, erythromycin, clindamycin resistance rates were ≥ 30%; Klenow pneumonia Escherichia coli, Haemophilus influenzae and Acinetobacter baumannii were 30.5% -59.6% resistant to cotrimoxazole. Escherichia coli and Acinetobacter baumannii showed no resistance to the three generations of cephalosporins, ampicillin / Sulbactam resistance rate of 27.7% to 34.0%. Conclusion The clinical treatment of children with lower respiratory tract infection should be based on the pathogen and susceptibility results of rational use of drugs to reduce the generation of drug-resistant strains.