儿科药学杂志2025，Vol.31Issue(3)：44-48,5.DOI:10.13407/j.cnki.jpp.1672-108X.2025.03.011
14岁以下儿童下呼吸道感染病原菌分布和耐药性分析
Distribution and Antimicrobial Resistance Analysis of Pathogens in Lower Respiratory Tract Infection in Children Under 14 Years Old
摘要
Abstract
Objective:To analyze the distribution and antimicrobial resistance of pathogens in children with lower respiratory tract infection,so as to provide reference for clinical empirical diagnosis and treatment.Methods:The pathogenic bacteria distribution and seasonal variation of lower respiratory tract infection in children under 14 years old admitted into the Second Affiliated Hospital of Nanjing Medical University from 2021 to 2023 were retrospectively analyzed,and the drug susceptibility test results of key bacteria were analyzed.Results:A total of 711 strains were detected,among which 329 cases were Gram positive,accounting for 46.3％;380 cases were Gram negative strains,accounting for 53.5％;2 strains were fungi,accounting for 0.3％.The top five bacteria in terms of isolation rates were respectively Escherichia coli(121 strains),Staphylococcus aureus(114 strains),Streptococcus pneumoniae(87 strains),Haemophilus influenzae(83 strains),and Klebsiella pneumoniae(48 strains).The seasonal distribution showed the highest detection rate in spring,followed by winter.Infant and early childhood were the age stages with the highest detection rate of the top five pathogens.The phenotypic detection rates of extended-spectrum β lactamases(ESBLs)in E.coli and K.pneumoniae were 48.3％and 25.8％,respectively.According to the results of drug sensitivity,E.coli were highly sensitive to imipenem,piperacillin/tazobactam,amikacin,cefepime and cefotetan(＞95％).K.pneumoniae had a high sensitivity rate to aminoglycosides,tetracyclines,and cotrimoxazole,mostly above 90％,yet the resistance rate to carbapenems was from 21.6％to 27.3％.The positive rate of β lactamase in H.influenzae was 54.7％,and the resistance rate to ampicillin was 93.0％.The resistance rate of S.aureus to penicillin and erythromycin was 91.2％and 52.7％,respectively.The detection rate of methicillin-resistant S.aureus(MRSA)was 37.7％.S.pneumoniae was 100％resistant to erythromycin and 84.7％resistant to tetracycline.S.aureus and S.pneumoniae resistant to vancomycin and linezolid were not detected.Conclusion:The main pathogens of lower respiratory tract infection in children are Gram negative bacteria,and the drug resistance of the main pathogens is severe,especially oxacillin-resistant S.aureus,penicillin-resistant S.pneumoniae and carbapename-resistant K.pneumoniae,which poses a serious threat to clinical anti-infection treatment.Pediatric clinical drug resistance monitoring and effective infection control measures should be strengthened.关键词
儿童/呼吸道感染/病原菌/耐药性Key words
children/respiratory infection/pathogens/drug resistance分类
医药卫生引用本文复制引用
蔡惠惠,张莉,王义俊,赵艳丰..14岁以下儿童下呼吸道感染病原菌分布和耐药性分析[J].儿科药学杂志,2025,31(3):44-48,5.基金项目
江苏省药学会-奥赛康医院药学基金科研项目,编号A202111. （）
