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目的探讨我院儿童社区获得性肺炎(CAP)细菌感染情况及药敏情况,为抗生素的合理使用提供依据。方法以本院2010年1月至2013年12月儿科收治的CAP患儿为研究对象,回顾性分析CAP的病原菌分布和耐药情况。菌株鉴定使用法国梅里埃VITEK32分析仪,用纸片扩散法做药敏试验。结果病原菌以革兰阴性菌为主,前四位分别为肺炎克雷伯杆菌、大肠埃希菌、流感嗜血杆菌和阴沟肠杆菌;革兰阳性菌次之,主要为肺炎链球菌和金黄色葡萄球菌。药敏结果显示,主要革兰阴性菌对头孢吡肟、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦和亚胺培南耐药率较低;主要革兰阳性菌对左氧氟沙星、莫昔沙星和万古霉素耐药率较低。结论了解CAP患儿病原菌分布,有利于在儿童CAP经验性治疗时制定正确的治疗方案。
Objective To investigate the prevalence of bacterial community-acquired pneumonia (CAP) in children in our hospital and its susceptibility to antibiotics, and to provide a basis for the rational use of antibiotics. Methods The pediatric patients admitted to our hospital from January 2010 to December 2013 were enrolled in this study. The pathogen distribution and drug resistance of CAP were retrospectively analyzed. Strain identification using France Merier VITEK32 analyzer, disk diffusion method to do drug sensitivity test. Results The gram-negative bacteria were the main pathogens, the first four were Klebsiella pneumoniae, Escherichia coli, Haemophilus influenzae and Enterobacter cloacae, followed by Gram-positive bacteria, mainly Streptococcus pneumoniae and golden yellow staphylococcus. Drug susceptibility results showed that the resistance rates of major gram-negative bacteria to cefepime, piperacillin / tazobactam, cefoperazone / sulbactam and imipenem were low; the main Gram-positive bacteria had a lower resistance to levofloxacin, Moxifloxacin and vancomycin lower rates of resistance. Conclusion Understanding the distribution of pathogens in children with CAP is conducive to the development of the correct treatment plan in children with CAP during the empirical treatment.