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目的探讨5岁以下患儿下呼吸道感染病原菌的流行特征,为临床治疗和合理制订患儿下呼吸道感染病原菌防控措施提供依据。方法回顾性分析2013年1月-2015年12月2 390例5岁以下急性下呼吸道感染患儿的痰培养和药敏试验结果。结果共分离出病原菌956株,分离阳性率为40.0%。其中革兰阳性菌359株,占37.6%,革兰阴性菌528株,占55.2%,真菌69株,占7.2%。革兰阳性菌中以肺炎链球菌和金黄色葡萄球菌为主,肺炎链球菌对青霉素耐药率低、对复方新诺明、四环素、红霉素耐药率较高,金黄色葡萄球菌耐药性相对较低。革兰阴性菌以大肠埃希菌、肺炎克雷伯菌、流感嗜血杆菌、阴沟肠杆菌等为主,对氨苄西林、哌拉西林耐药率较高,敏感的抗菌药物为β-内酰胺酶抑制剂复合剂、亚胺培南、氟喹诺酮类。结论根据药敏试验结果联合用药,对治疗患儿下呼吸道感染及减少临床耐药菌株有重要的临床意义。
Objective To explore the epidemiological characteristics of pathogenic bacteria of lower respiratory tract infection in children under 5 years of age and provide the basis for clinical treatment and reasonable formulation of prevention and control measures of pathogenic bacteria of lower respiratory tract infection in children. Methods The sputum culture and drug sensitivity test results of 2 390 children under 5 years old with acute lower respiratory tract infection from January 2013 to December 2015 were analyzed retrospectively. Results A total of 956 pathogens were isolated and the positive rate was 40.0%. Among them, 359 Gram-positive bacteria accounted for 37.6%, 528 Gram-negative bacteria accounted for 55.2% and 69 fungi accounted for 7.2%. Gram-positive bacteria in Streptococcus pneumoniae and Staphylococcus aureus-based, Streptococcus pneumoniae resistance to penicillin is low, the new cotrimoxazole, tetracycline, erythromycin high resistance rate, Staphylococcus aureus resistance Sex is relatively low. Gram-negative bacteria Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae, Enterobacter cloacae, etc., the higher rate of resistance to ampicillin, piperacillin, sensitive antibacterial drugs for the β-lactam Enzyme Inhibitor Complex, Imipenem, Fluoroquinolones. Conclusions According to the results of drug susceptibility test combined with the treatment of children with lower respiratory tract infection and reduce clinical resistant strains have important clinical significance.