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目的:了解房山区儿童社区获得性肺炎细菌病原学分布及耐药情况。方法:选择2010~2012年在房山区良乡医院儿科住院的5岁及以下儿童共2 500例作为研究对象,入院后采集患儿痰液标本并进行细菌培养和耐药性检测。数据采用SPSS 17.0软件进行统计分析。结果:2 500例痰标本中共检出细菌853株,检出率为34.12%(853/2 500),其中革兰阴性菌、革兰阳性菌分别检出605例和248例,分别占检出细菌总株数的70.93%(605/853)和29.07%(248/853)。革兰阴性菌中,肺炎克雷伯杆菌、流感嗜血杆菌、阴沟肠杆菌所占比例较高,分别占总检出株数的20.28%、15.71%和12.78%。革兰阳性菌中肺炎链球菌所占比例最高,为10.90%。获得性肺炎儿童感染的革兰阴性菌对氨苄西林、哌拉西林钠、头孢唑啉、头孢呋辛、头孢噻肟钠、头孢他啶的耐药率均较高,对亚胺培南的耐药率最低;革兰阳性菌对克林霉素、红霉素、青霉素的耐药率较高,对氨苄西林/舒巴坦耐药率较低,对万古霉素不耐药。结论:调查地区儿童社区获得性肺炎细菌病原均以革兰阴性菌为主,对氨苄西林、哌拉西林钠、头孢唑啉、头孢呋辛、头孢噻肟钠、头孢他啶等耐药率较高,应加强监测,防止耐药菌流行。
Objective: To understand the etiological distribution and drug resistance of community acquired pneumonia in Fangshan district. Methods: A total of 2 500 children aged 5 years and below who were hospitalized in Liangxiang Hospital of Fangshan District from 2010 to 2012 were selected as research objects. After admission, sputum samples from children were collected and tested for bacterial culture and drug resistance. Data using SPSS 17.0 software for statistical analysis. Results: A total of 853 bacterial strains were detected in 2 500 sputum samples, the detection rate was 34.12% (853/2 500). Among them, 605 cases and 248 cases of Gram-negative bacteria were detected respectively, accounting for The total bacterial count was 70.93% (605/853) and 29.07% (248/853). Gram-negative bacteria, Klebsiella pneumoniae, Haemophilus influenzae, Enterobacter cloacae accounted for a higher proportion, respectively, the total number of detected strains of 20.28%, 15.71% and 12.78%. Gram-positive bacteria in the highest proportion of Streptococcus pneumoniae, 10.90%. Gram-negative bacteria infected children with acquired pneumonia were more resistant to ampicillin, piperacillin, cefazolin, cefuroxime, cefotaxime sodium and ceftazidime than those with imipenem The lowest; Gram-positive bacteria clindamycin, erythromycin, penicillin higher resistance rate, lower resistance to ampicillin / sulbactam, vancomycin resistance. CONCLUSIONS: Gram-negative bacteria were the main pathogens of community-acquired pneumonia in children in the survey area. The rates of resistance to ampicillin, piperacillin, cefazolin, cefuroxime, cefotaxime and ceftazidime were high, Monitoring should be strengthened to prevent the spread of drug-resistant bacteria.