我院小儿肺炎致病菌分布及其耐药性现状.docVIP

　　我院小儿肺炎致病菌分布及其耐药性现状 作者：安淑华，宋庆，史玲艾，袁亚茹，武芳 【摘要】 目的：了解河北省儿童 医院 小儿肺炎病原菌分布及耐药情况。方法：收集2005年2月～2006年11月我院收治的736例确诊为肺炎患儿的痰标本行细菌培养及药敏分析。结果：736例痰标本中分离致病菌18种共335株，总阳性率为45.5%，以革兰阴性杆菌（G杆菌）为主，占81.5%，革兰阳性菌（G+菌）占18.5%。G菌对青霉素类及头孢类抗生素耐药率高，其中肺炎克雷伯菌及大肠埃希菌中产超广谱β内酰胺酶（ESBLs）率分别高达64.9%、67.2%，对哌拉西林/他唑巴坦、头孢西丁耐药率低，对美罗培南敏感。G+菌对青霉素、头孢唑林、克林霉素、红霉素、复方新诺明（SMZ）耐药率高，对美罗培南耐药率为0，对万古霉素、利福平、左氧氟沙星、加替沙星敏感。结论：本院小儿肺炎致病菌以G杆菌占优势，不同菌种对抗生素的耐药性存在差异。非发酵G杆菌、肺炎克雷伯菌和大肠埃希菌多重耐药现象严重，非发酵菌耐药性比产ESBLs的肺炎克雷伯菌和大肠埃希菌更高。 【关键词】 小儿；肺炎；耐药；病原菌；超广谱β内酰胺酶；痰培养 ［Abstract］ Objective:To investigate the bacterial distribution and drugsensitivity of pediatric patients onia in our children，s hospital. Methods: Bacterial identification and susceptibility test specimens of pediatric patients onia in Childrens Hospital from Feb. 2005 to Nov. 2006. Results: In 763 cases, 18 pathogenic bacteria and 335 strains the sputum samples, the total positive rate negative bacilli oniae, Escherichia coli, Pseudomonas aeruginos, Aciobacter species, other Nonfermenters, Serratia liquefaciens, Haemophilus, accounting for 81.5%. Grampositive bacilli oniae, Staphylococcus epidermidis, and Staphylococcus aureus accounted for 18.5%. Gramnegative bacilli oniae and Escherichia coli oniae . Grampositive bacilli to penicillins, cefazolin, Clindamycim, Erythromycin and SMZ , Vanycin, Rifampin, Levofloxacin Gatifloxacin. Conclusions: The most mon pathogenic bacterias of the pediatric patients onia onia, Escherichia coli, Pseudomonas aeruginose, Aciobacter species, Streptococcus pneumoniae, Staphylococcus epidermidis and other Nonfermenters. Gramnegative bacilli ajor pathogenic bacteria, and the resistance of the different types of bacilli enters, Klebsiella pneumoniae and Escherichia coli. bees a serious problem. The drug resistant rate of Nonfermenters oniae and Escherichia coli. ［Key onia; Drug resistance; Pathogenic bacteria; Extended spectrum βlactamase; Sputum culture 肺炎是儿科最常见的疾病，是5岁以下儿童的主要死亡原因之一，重症肺炎多存在细菌感染。近年来由于抗菌药物的更新换代及人为滥用，新病原与病原变异