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| 2013~2015年某医院儿童社区获得性肺炎病原菌分布及耐药特征 |
| Analysis of Pathogens Distribution and Drug resistance of Children with Community acquired Pneumonia in a Hospital from 2013 to 2015 |
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| DOI： |
| 中文关键词: 儿童 社区获得性肺炎 病原菌 抗菌药 耐药率 |
| 英文关键词:Children Community acquired pneumonia Pathogen Antibacterial drug Resistant rate |
| 基金项目:国家自然科学基金项目（编号：81401696）；山东省科技发展计划项目（编号：2012G0021844）；山东省重点研发计划项目（编号：2016GSF201078） |
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| 中文摘要: |
| 摘 要 目的：了解儿童社区获得性肺炎（CAP）的病原菌分布特征及耐药性的变化趋势。方法：对某医院2013~2015年儿科CAP患者呼吸道分离的病原菌进行鉴定及药敏试验，根据美国临床实验室标准化协会（CLSI）2014年版标准判读结果，采用WHONET 5.6 软件统计数据。结果：引起儿童CAP感染的主要病原菌为肺炎链球菌、流感嗜血杆菌、卡他莫拉菌、金黄色葡萄球菌及大肠埃希菌，且前3种细菌占各年分离的病原菌构成比逐年增加；肺炎链球菌对青霉素耐药率低于10%，流感嗜血杆菌及卡他莫拉菌产β 内酰胺酶的比例较高，对第三代头孢菌素及美罗培南的耐药率较低。甲氧西林耐药金黄色葡萄球菌（MRSA）的检出率逐年增高，但未发现对万古霉素及利奈唑胺耐药的菌株出现。大肠埃希菌及肺炎克雷伯菌对碳青霉烯耐药率仍较低，但耐药率呈现逐年增高的趋势。结论：儿童CAP感染的病原菌种类与成人不同，病原菌耐药性不容乐观，根据病原菌耐药情况给予经验性抗菌药治疗对于改善CAP患儿的预后具有重要意义。 |
| 英文摘要: |
| ABSTRACT Objective:To investigate the distribution characteristics and drug resistance of pathogens in children with community acquired pneumonia (CAP). Methods:The pathogens isolated from respiratory tract of patients in pediatric with CAP in a hospital from 2013 to 2015 were identified and drug susceptibility tests were carried out. The results were assessed according to clinical laboratory standard institute (CLSI) 2014 edition standard. WHONET 5.6 software was used for drug resistance analysis. Results: The top five pathogens causing CAP in children were Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and Escherichia coli.The detection rates of the first three bacteria were increasing annually over the past three years. The resistant rate to penicillin of Streptococcus pneumoniae was less than 10%. The detection rates of Haemophilus influenzae and Moraxella catarrhalis that producing beta lactamase was high, while resistant rates to the third generation cephalosporin and meropenem were lower. Although the number of Methicillin resistant staphylococcus aureus (MRSA) was increasing year by year, there were no strain that showed resistant to vancomycin and linezolid. The resistant rates to carbapenem of Escherichia coli and Klebsiella pneumoniae were still low, but showed an increasing trend. Conclusion:The pathogens of CAP infection in children were different from adults. The drug resistance of pathogens wass not optimistic. Empiric antimicrobial therapy based on drug resistance was helpful to improve the prognosis of children with community acquired pneumonia. |
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