儿童呼吸道感染细菌耐药性分析.docVIP

儿童呼吸道感染细菌耐药性分析 　　 　　摘 要 目的：研究本地区儿童急性呼吸道感染细菌对抗生素的耐药状况。方法：2008年9月～2010年8月收治急性呼吸道感染患儿783例，采集患儿呼吸道的分泌物进行细菌培养鉴定和药敏分析。结果：783份标本分离出细菌190株，其中革兰阳性菌97株（51.05%），以肺炎链球菌和金黄色葡萄球菌为主；革兰阴性菌93株（48.95%），以肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌为主。肺炎链球菌对β内酰胺类抗生素普遍敏感，对红霉素高度耐药。金黄色葡萄球菌对苯唑青霉素、复方新诺明仍较敏感，对万古霉素、喹奴普汀/达福普汀非常敏感，对头孢唑啉、红霉素高度耐药。革兰阴性菌对亚胺培南、美罗培南非常敏感，对哌拉西林/他唑巴坦、阿米卡星、庆大霉素、环丙沙星仍较敏感，对青霉素类、第一代头孢耐药率较高，对第二、三代头孢也有一定的耐药。结论：应根据本区域近期病原菌谱及药敏情况选择合适抗菌药物，在病原菌未明确的小儿呼吸道感染可首选苯唑西林和哌拉西林/他唑巴坦，对耐药性较强的感染可选用万古霉素或碳青酶烯类抗菌药。 　　关键词 儿童 呼吸道感染 细菌 耐药性 　　AbstractObjective:To study this district children acute respiratory infection bacteria resistant to antibiotic medicines condition.Methods:Selection 2008 September until 2010 August hospitalized children with acute respiratory infection 783 example,collected the respiratory secretions of children to make the bacteria culture and drug sensitivity analysis.Results:Of 783 specimens,190 case were isolated have bacteria,including 97 case of gram-positive bacteria,accounting for 51.05%,streptococcus pneumoniae,and staphylococcus aureus were mainly,Gram-negative bacterium 93 case,accounting for 48.95%,Klebsiella pnenmoniae,escherichia coli,enterobacter cloacae were mainly.Streptococcus pneumoniae was common sensitive to β-lactamase-producing class antibiotic,highly resistant to erythromycin.Staphylococcus aureus was still relatively sensitive to benzene thiazole penicillin and compound sulfonamides methyl isopropyl evil thiazol,highly resistant to Cefazolin and erythromycin,very sensitive to vancomycin and Quinupristin-dalfopristin.Gram-negative bacterium were very sensitive to imipenem and Meropenem,still relatively sensitive to piperacillin/Tazobactam,amikacin,gentamycin and ciprofloxacin,highly resistant to the penicillin class and the first-generation cephalosporins,partly resistant to the second and third-generations cephalosporins.Conclusion:Choose the appropriate antibiotic drugs must according to the regional recent pathogen pedigree and the drug sensitive situation,before the path