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目的分析婴幼儿大肠埃希菌性肺炎患儿的临床特征及药敏情况,指导临床肺炎诊治。方法回顾性分析177例住院婴幼儿大肠埃希菌性肺炎患儿的临床表现、X线表现、细菌耐药情况及治疗预后。结果患儿的临床表现主要的症状为咳嗽、咳痰、发热,容易出现呼吸困难。X线主要表现为片状影或间质渗出。大肠埃希菌多数菌株对泰能、美平、头孢他定、丁胺卡那霉素、左氧氟沙星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦敏感性高,对大多数β内酰胺类抗生素普遍耐药。产超广谱β内酰胺酶(ESBLs)菌33例,阳性率为18.6%。痰液培养细菌阳性转阴比较慢,治疗主要以经验疗法和药敏试验结果结合,病程迁延,预后尚好。结论婴幼儿大肠埃希菌肺炎是儿科常见病,临床诊治相对容易。但大肠埃希菌抗菌药物的耐药率高,需引起重视。
Objective To analyze the clinical characteristics and drug susceptibility of infants with Escherichia coli pneumonia and to guide clinical diagnosis and treatment of pneumonia. Methods The clinical manifestations, X-ray findings, bacterial resistance and prognosis of 177 hospitalized infants with Escherichia coli pneumonia were retrospectively analyzed. Results The main symptoms of children with clinical manifestations of cough, sputum, fever, prone to breathing difficulties. X-ray showed mainly flake or interstitial effusion. Most strains of Escherichia coli had high sensitivity to tenecan, mebendin, ceftazidime, amikacin, levofloxacin, piperacillin / tazobactam, cefoperazone / sulbactam, and most β Lactam antibiotics are generally resistant. 33 cases of extended-spectrum β-lactamase (ESBLs) bacteria, the positive rate was 18.6%. Sputum culture positive bacteria overcast more slowly, the treatment is mainly combined with empirical therapy and susceptibility test results, duration of the disease, the prognosis is still good. Conclusion Escherichia coli pneumonia in infants and young children is a common pediatric disease, clinical diagnosis and treatment is relatively easy. However, the drug resistance rate of Escherichia coli antibiotics is high and needs attention.