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儿童社区获得性肺炎病原菌分布及其耐药性变迁分析

严清华 黄友旗 李勰辚 蔺增榕 郭伟中 李仕杰 林世江 杨华彬 蔡於才

国际医药卫生导报2012,Vol.18Issue(19):2804-2807,4.
国际医药卫生导报2012,Vol.18Issue(19):2804-2807,4.DOI:10.3760/cma.j.issn.1007-1245.2012.19.005

儿童社区获得性肺炎病原菌分布及其耐药性变迁分析

Changes of pathogens and drug resistance in community-acquired pneumonia in children

严清华 1黄友旗 2李勰辚 3蔺增榕 4郭伟中 5李仕杰 6林世江 7杨华彬 8蔡於才9

作者信息

  • 1. 510170 广州医学院荔湾医院医院感染管理科
  • 2. 510375 广州市荔湾区妇幼保健院
  • 3. 510170 广州医学院荔湾医院检验科
  • 4. 510170 广州医学院荔湾医院儿科
  • 5. 528300佛山,顺德区妇幼保健院
  • 6. 523002 东莞市妇幼保健院检验科
  • 7. 512000 韶关市第一人民医院儿科
  • 8. 510120 广州市儿童医院儿科
  • 9. 510150广州,广州医学院附属第三医院医院感染管理科
  • 折叠

摘要

Abstract

Objective To analyze the changes of pathogens and drug resistance in communityacquired pneumonia ( CAP ) in children to provide guidence for optimal uses of antibiotics.Methods Sputum samples from 4806 children with CAP at seven hospitals were cultured.Bacterial strains were isolated and identified by API or the MicroScan WalkAway 40 SI.Antimicrobial susceptibility was tested;and ESBLs,AmpC,and MRS were examined according to the criteria of NCCLS guidelines.The WHONET 5.0 software was used for analysis of antimicrobial resistance.Results Among 1127 isolated pathogenic strains,628 ( 55.7% )were gram-negative,mostly Klebsiella pneumoniae,followed by Escherichia coli,466 ( 41.4% )were gram-positive cocci,mostly Streptococcus penumoniae,followed by Staphylococcus aureus; 33 ( 2.9% )were Candida.Gram-negative bacilli had the highest resistant rate ( 91.4% - 94.3% )to ampicillin and the first generation of cephalosporins,but is susceptible to imipenem.The rates of producing ESBLs and AmpC were 58.8% and 19.8% for Klebsiella pneumonia and 55.0% and 12.3% for Escherichia coli,respectively.Gram-positive cocci had the highest resistant rate ( 93.3% - 100.0% ) to penicillin,oxacillin sodium,and erythromycin.Conclusions The main pathogens for CAP in children were gramnegative strains and gram-positive cocci.Due to the frequent uses of β-lactams and macrolides in the department of pediatrics,pathogens produce ESBLs and AmpC highly.The pathogens have severe drug resistance to antibiotics.It is of importance for sputum cultures and testing antimicrobial resistance.

关键词

儿童/社区获得性肺炎/病原菌/细菌耐药性/痰培养

Key words

Children/Community-acquired pneumonia/Pathogens/Drug resistance/Sputum cultures

引用本文复制引用

严清华,黄友旗,李勰辚,蔺增榕,郭伟中,李仕杰,林世江,杨华彬,蔡於才..儿童社区获得性肺炎病原菌分布及其耐药性变迁分析[J].国际医药卫生导报,2012,18(19):2804-2807,4.

基金项目

广东省医学科研基金立项(A2010503) (A2010503)

国际医药卫生导报

1007-1245

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