660例小儿肺炎病原学及耐药性研究.doc

660例小儿肺炎病原学及耐药性研究【摘要】目的：探讨小儿肺炎的病原学及耐药性。方法：采用无菌吸痰管连接负压吸引器吸取660例小儿肺炎咽部的痰液，对标本进行细菌学培养，测定药物敏感性。结果：分离菌中，以革兰阴性细菌居首位，占62.99%，大肠埃希菌及肺炎克雷伯菌为主要菌种，美洛培南、亚胺培南、环丙沙星最敏感；其次为革兰阳性细菌，占37.11%，以链球菌及金黄色葡萄菌为主，对万古霉素、头孢哌酮、头孢噻肟最敏感。结论：结果显示小儿肺炎革兰阴性细菌为主，并出现多重耐药。抗生素治疗应根据细菌学指导选择敏感的抗生素，在未获得明确病原菌之前，应根据感染流行趋势，根据小儿的特点经验性选择合适的抗生素治疗。 【关键词】肺炎；小儿；病原菌；耐药性 文章编号：1009-5519（2007）20-3007-03 中图分类号：R72 文献标识码：A Analysis of etiology and drug resistance of 660 cases of infantile pneumonia YANG Ying (Department of Pediatrics，Chongqing General Hospital，Chongqing 400081，China) 【Abstract】Objective:To analyse the etiology and drug resistance of infantile pneumonia，so as to instruct the ratinal use of medicine.Methods:The sputum of deep pharynx from 660 cases of infantile pneumonia was collected by aseptic sucker tube connected with aspirator of negative pressure.The sputum samples were cultured and isolated respectively.Results:Gram-negative bacteria took the first place,accounting for 62.99% of all isolated strains in infantile pneumonia,in which escherichia coli and klebsiella pneumoniae were the main strains,and meropenem,imipenem and ciprofloxacin were most sensitive for gram-negative bacteria;The next strains were Gram-positive bacteria,accounting for 37.11%,in which Streptococcus and Staphylococcus aureus were the main strains,and vancomycin,cefoperazone and cefotaxime were most sensitive for Gram-positive bacteria.Conclusion:The main pathogenic bacteria of infantile pneumonia might be Gram-negative bacteria,with multi-drug resistance.Antibiotic treatment should depend on the type of pathogenic bacteria and drug sensitivity test to choose the sensitive antibiotic.The effective and suitable antibiotic should be chosen by iatric clinical experience before drug sensitivity test. 【Key words】Pnemonia；Infantile；Pathogenic bacteria；Drug resistance 为了解本地区小儿肺炎的细菌感染情况及抗生素的耐药情况，指导临床用药。现对我院近2年小儿肺炎的痰培养的检出细菌及药敏进行回顾性分析，并报道如下。 1 资料与方法 1.1 一般资料：收集2005年1月~2007年1月我院儿科小儿肺炎的痰培养标本660份。其中男344例，女316例，7岁66例，诊