【摘要】 目的:分析我院细菌性肺炎儿童下呼吸道痰培养病原菌分布及耐药情况,指导临床合理使用抗菌药。方法:选取2013年1月～2018年1月我院感染细菌性肺炎的儿童,采集患儿下呼吸道痰液。培养分离出病原菌,并对其进行药敏试验。结果:细菌性肺炎儿童的下呼吸道的合格痰标本中共分离出病原菌7826株病原菌,其中革兰阴性菌4931株,分布较多的是肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌、流感嗜血杆菌和铜绿假单胞菌等;革兰阳性菌2503株,分布较多的是金黄色葡萄球菌、肺炎链球菌,表皮葡萄球菌株等;另检出真菌392株。革兰氏阳性球菌对青霉素和红霉素耐药出现较高的耐药性,对替考拉宁、庆大霉素、利奈唑胺、万古霉素和亚胺培南未出现耐药性。革兰阴性菌对头孢唑林、头孢西丁、头孢噻肟和氨曲南均出现较高的耐药性,对亚胺培南未出现耐药性。结论:我院细菌性肺炎儿童下呼吸道痰培养中分离的病原菌以革兰阴性细菌为主,耐药现象比较多见。临床上应对痰培养给予高度重视,根据药敏结果应用抗生素,并加强耐药性监测管理。更多还原

【Abstract】 Objective To analyze the distribution and drug resistance of pathogenic bacteria in sputum of lower respiratory tract in children with bacterial pneumonia in our hospital and to guide the rational use of antibacterials in clinic.Methods From JJanuary 2013 to January 2018,children with bacterial pneumonia in our hospital were collected and the sputum of lower respiratory tract was collected.Its bacterial culture and drug susceptibility testing.Results 7826 strains of pathogenic bacteria were isolated from qualified sputum of lower respiratory tract of children with bacterial pneumonia,Gram-negative bacteria which 4931 strains,more distribution of Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii,Haemophilus influenzae and Pseudomonas aeruginosa and so on;Gram-positive bacteria 2503 strains,the distribution is more Staphylococcus aureus,Streptococcus pneumoniae,Staphylococcus epidermidis strain.Gram-positive cocci penicillin and erythromycin resistance appeared higher resistance,no resistance to teicoplanin,gentamicin,linezolid,vancomycin and imipenem;392 strains of fungi were detected.Gram-negative bacteria showed higher resistance to cefazolin,cefoxitin,cefotaxime and aztreonam,no resistance to imipenem.Conclusion The pathogenic bacteria isolated from sputum of lower respiratory tract in children with bacterial pneumonia in our hospital are mainly gram-negative bacteria,and the resistance is more common.To deal with the sputum culture clinically give great importance to the application of antibiotics based on drug susceptibility results and to strengthen drug resistance monitoring and management.更多还原