【摘要】 目的对先天性心脏病(CHD)患儿医院获得性肺炎(HAP)的危险因素及病原菌耐药性进行研究,为其预防和控制及抗菌药物的合理使用提供科学依据。方法对HAP患儿的年龄分布、危险因素、病原菌的分布及对抗菌药物的耐药性进行分析。结果CHD患儿HAP以<1岁婴儿多见;病原菌分布以革兰阴性杆菌为主(64.6%),其次为革兰阳性球菌(25.6%)和真菌(9.8%);革兰阴性杆菌中前3位分别为肺炎克雷伯菌、大肠埃希菌和铜绿假单胞菌,革兰阳性球菌对青霉素高度耐药,对万古霉素高度敏感;主要革兰阴性杆菌对头孢菌素有较高耐药性,对亚胺培南等较敏感。结论CHD患儿HAP发生的危险因素主要为年龄因素及CHD等,病原菌以革兰阴性杆菌为主,对头孢菌素有较高耐药性。更多还原

【Abstract】 OBJECTIVE To provide the scientific basis for prevention and control of hospital-acquired pneumonia(HAP) in children with congenital heart disease(CHD),and application of antibiotic through the research on dangerous factors and the drug resistance of disease germ.METHODS The age distributions of children with HAP,the risk factors,the patogenic bacteria distribution,and the drug resistance to the antibiotics were analyzed.RESULTS The most HAP patients were less than 1 year old children with CHD.The main germs were Gram-negative bacteria(64.6%),and then Gram-positive bacteria(25.6%) and fungi(9.8%),while the top-three were Klebsiella pneumoniae,Escherichia coli and P.aeruginosa from Gram-negative bacteria which had the higher drug resistance to the cephalosporin,and sensitive to imipenem.The Gram-positive bacteria were highly resistant to penicillin,and highly sensitive to vancomycin.CONCLUSIONS The risk factors of HAP for CHD children are age(infancy),CHD,etc.The main underlying germs are Gram-negative bacteria,which are highly resistant to cephalosporins.更多还原