儿童呼吸内科下呼吸道分离菌分布及药敏分析(1)
摘要：目的 分析我院儿童呼吸内科下呼吸道标本分离菌的分布及其耐药情况，为临床治疗用药提供参考。方法 对我院2016年7月～2018年6月呼吸内科送检的4137例下呼吸道标本分离菌进行收集，并进行药敏试验。结果 4317例送检标本中共分离出2060株(去除重复菌株)，其中革兰阴性菌1437株，占69.75%;革兰阳性菌623株，占30.25%。排前五的分离菌依次为流感嗜血杆菌(41.02%)、肺炎链球菌(21.17%)、卡他莫拉菌(19.03%)、金黄色葡萄球菌(8.98%)、肺炎克雷伯菌(3.83%)。流感嗜血杆菌、卡他莫拉菌对头孢噻肟、利福平、氧费沙星全部敏感;对氨苄西林、复方新诺明敏感性低。肺炎链球菌、金黄色葡萄球菌对利奈唑胺、万古霉素全部敏感;对红霉素敏感性低。结论 儿童下呼吸道病原菌种类多样，主要为革兰阴性菌，应依据病原菌的种类及药敏特点选择有针对性的高效抗菌药物，制定个体化治疗方案，减少耐药菌株的产生。
关键词：下呼吸道;病原菌;分布;耐药性
, http://www.100md.com 中图分类号：R378 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.03.043
文章编号：1006-1959(2019)03-0134-03
Abstract：Objective To analyze the distribution and drug resistance of the isolates of respiratory tract specimens in children's respiratory medicine in our hospital， and provide reference for clinical treatment. Methods 4137 cases of lower respiratory tract specimens collected from our Department of Respiratory Medicine from July 2016 to June 2018 and tested for drug susceptibility. Results A total of 2060 strains (removed duplicate strains) were isolated from 4317 specimens， including 1437 strains of Gram-negative bacteria， accounting for 69.75%， and 623 strains of Gram-positive bacteria， accounting for 30.25%. The top five isolates were Haemophilus influenzae (41.02%)， Streptococcus pneumonia (21.17%)， Moraxella catarrh (19.03%)， Staphylococcus aureus (8.98%)， Klebsiella pneumonia ( 3.83%). Haemophilus influenzae and Moraxella catarrhalis were all sensitive to cefotaxime， rifampicin and norfloxacin; they were less sensitive to ampicillin and cotrimoxazole. Streptococcus pneumoniae， Staphylococcus aureus are all sensitive to linezolid and vancomycin; low sensitivity to erythromycin. Conclusion Children's lower respiratory pa-thogens are diverse， mainly Gram-negative bacteria.Targeted high-efficiency antibacterial drugs should be selected according to the type of pathogens and drug sensitivity characte-ristics， and individualized treatment plans should be developed to reduce the emergence of drug-resistant strains.
, 百拇医药
Key words：Lower respiratory tract;Pathogenic bacteria;Distribution;Drug resistance
兒童属于一个敏感的特殊群体，由于先天呼吸道器官发育的不成熟及免疫系统的不完善，导致其对环境的适应力和抵抗力低下，比成人更易发生呼吸系统疾病[1]。呼吸系统感染已经成为了儿童最常见的疾病，是导致我国患儿死亡的主要原因之一[2]。儿童下呼吸道感染的病原体种类繁多，一般以细菌感染为常见[3]，随着近年来抗菌药物的大力研发和抗生素的广泛滥用，细菌耐药菌株的产生及其耐药性呈不断增加的趋势对临床用药治疗增加难度。本研究对我院2016年7月～2018年6月儿童下呼吸道分离菌分布及敏感性进行分析，从而为临床治疗合理用药提供参考，结果报告如下。, 百拇医药(彭杰 张琴)
关键词：下呼吸道;病原菌;分布;耐药性
, http://www.100md.com 中图分类号：R378 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.03.043
文章编号：1006-1959(2019)03-0134-03
Abstract：Objective To analyze the distribution and drug resistance of the isolates of respiratory tract specimens in children's respiratory medicine in our hospital， and provide reference for clinical treatment. Methods 4137 cases of lower respiratory tract specimens collected from our Department of Respiratory Medicine from July 2016 to June 2018 and tested for drug susceptibility. Results A total of 2060 strains (removed duplicate strains) were isolated from 4317 specimens， including 1437 strains of Gram-negative bacteria， accounting for 69.75%， and 623 strains of Gram-positive bacteria， accounting for 30.25%. The top five isolates were Haemophilus influenzae (41.02%)， Streptococcus pneumonia (21.17%)， Moraxella catarrh (19.03%)， Staphylococcus aureus (8.98%)， Klebsiella pneumonia ( 3.83%). Haemophilus influenzae and Moraxella catarrhalis were all sensitive to cefotaxime， rifampicin and norfloxacin; they were less sensitive to ampicillin and cotrimoxazole. Streptococcus pneumoniae， Staphylococcus aureus are all sensitive to linezolid and vancomycin; low sensitivity to erythromycin. Conclusion Children's lower respiratory pa-thogens are diverse， mainly Gram-negative bacteria.Targeted high-efficiency antibacterial drugs should be selected according to the type of pathogens and drug sensitivity characte-ristics， and individualized treatment plans should be developed to reduce the emergence of drug-resistant strains.
, 百拇医药
Key words：Lower respiratory tract;Pathogenic bacteria;Distribution;Drug resistance
兒童属于一个敏感的特殊群体，由于先天呼吸道器官发育的不成熟及免疫系统的不完善，导致其对环境的适应力和抵抗力低下，比成人更易发生呼吸系统疾病[1]。呼吸系统感染已经成为了儿童最常见的疾病，是导致我国患儿死亡的主要原因之一[2]。儿童下呼吸道感染的病原体种类繁多，一般以细菌感染为常见[3]，随着近年来抗菌药物的大力研发和抗生素的广泛滥用，细菌耐药菌株的产生及其耐药性呈不断增加的趋势对临床用药治疗增加难度。本研究对我院2016年7月～2018年6月儿童下呼吸道分离菌分布及敏感性进行分析，从而为临床治疗合理用药提供参考，结果报告如下。, 百拇医药(彭杰 张琴)