【摘要】：目的了解2013-2015年兒童下呼吸道感染常見致病菌類型及耐藥性變遷情況,為患者臨床治療提供科學(xué)指導(dǎo)。方法收集兒童呼吸道感染患者痰液樣本進(jìn)行病原菌培養(yǎng)和菌株鑒定,采用紙片擴(kuò)散法(K-B法)進(jìn)行藥敏試驗(yàn),分析病原菌耐藥性變遷情況。結(jié)果 1 743份下呼吸道感染患者痰液標(biāo)本中共分離出756株病原菌,其中肺炎鏈球菌275株,占36.38%;流感嗜血桿菌181株,占23.94%;卡他莫拉菌211株,占27.91%;其他菌89株,占11.77%。肺炎鏈球菌對青霉素耐藥率為100.00%,對阿莫西林、復(fù)方新諾明、氯霉素、紅霉素、克林霉素、頭孢噻肟等的耐藥率分別為72.36%、35.27%、26.55%、85.09%、74.55%和0.73%,未檢出對頭孢曲松和左氧氟沙星耐藥菌株。流感嗜血桿菌對氨芐西林、利福平、氯霉素、四環(huán)素、頭孢噻肟和頭孢曲松的耐藥率分別為59.67%、2.76%、22.10%、33.15%、0.55%和0.55%,對利福平、頭孢曲松和頭孢噻肟較敏感;流感嗜血桿菌對氨芐西林耐藥率較高,對利福平、頭孢曲松和頭孢噻肟較敏感。卡他莫拉菌對青霉素、阿莫西林、氨芐西林、利福平、苯唑西林、呋喃妥因、頭孢噻肟和頭孢曲松耐藥率分別為100.00%、76.67%、73.46%、29.38%、35.07%、24.17%、1.42%和0.95%;卡他莫拉菌對青霉素已經(jīng)完全耐藥,對頭孢噻肟和頭孢曲松仍然敏感。結(jié)論 2013-2015年兒童下呼吸道感染常見致病菌為肺炎鏈球菌、流感嗜血桿菌以及卡他莫拉菌,各菌株對青霉素耐藥明顯,對頭孢菌素類抗生素相對敏感,臨床治療中可優(yōu)先考慮。
[Abstract]:Objective to investigate the changes of common pathogenic bacteria and drug resistance in children with lower respiratory tract infection from 2013 to 2015, and to provide scientific guidance for clinical treatment. Methods sputum samples from children with respiratory tract infection were collected for pathogen culture and bacterial identification. Drug susceptibility test was performed by disk diffusion method (K) to analyze the change of drug resistance of pathogenic bacteria. Results A total of 756 strains of pathogenic bacteria were isolated from sputum samples of patients with lower respiratory tract infection, of which 275 strains were Streptococcus pneumoniae (36.38%), 181 strains were Haemophilus influenzae (23.94%), 211 strains (27.91%) were Moraxella catarrhalis, and 7 strains were Streptococcus pneumoniae (36.38%). Other bacteria were 89 strains (11.77%). The resistance rate of Streptococcus pneumoniae to penicillin was 100.00%, and to amoxicillin, compound nomaxime, chloramphenicol, erythromycin, clindamycin, cefotaxime was 72.36%, 35.27%, 26.55%, 85.09%, respectively. 74.55% and 0.73% of the isolates were resistant to ceftriaxone and levofloxacin. The resistance rates of Haemophilus influenzae to ampicillin, rifampicin, chloramphenicol, tetracycline, cefotaxime and ceftriaxone were 59.67%, 2.76%, 22.10%, 33.15%, 0.55% and 0.55%, respectively. Ceftriaxone and cefotaxime were sensitive; Haemophilus influenzae was resistant to ampicillin and sensitive to rifampicin, ceftriaxone and cefotaxime. The resistance rates to penicillin, amoxicillin, ampicillin, rifampin, oxacillin, furantoin, cefotaxime and ceftriaxone were 100.00%, 76.67%, 73.46%, 29.38%, 35.07%, respectively. 24.17%, 1.42% and 0.95%; Moraxella catarrhalis is completely resistant to penicillin and remains sensitive to cefotaxime and ceftriaxone. Conclusion from 2013 to 2015, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis were the most common pathogens in children with lower respiratory tract infection. The strains were resistant to penicillin and relatively sensitive to cephalosporins, which could be given priority in clinical treatment.
【作者單位】： 河南大學(xué)淮河醫(yī)院兒科;
【分類號】：R725.6

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