标题：2 639例下呼吸道感染患儿病原菌分布及耐药性分析

      作者：钟小珍，韦洁宏，莫红梅，张秀明    (深圳市罗湖区人民医院医学检验科，广东 深圳 518001)

      卷次： 2018年29卷14期

      【摘要】 目的 分析深圳市罗湖区人民医院下呼吸道感染患儿病原菌在不同性别、年龄、季节的分布特点及耐药性情况，指导临床合理用药。方法 对2014年5月至2017年4月在深圳市罗湖区人民医院治疗的2 639例下呼吸道感染患儿痰标本进行分离培养后予以细菌学鉴定和药敏试验，并进行统计分析。结果 检出病原菌1 431株，总阳性率为54.22%，其中革兰阴性菌占58.14%，以流感嗜血杆菌、卡他莫拉菌为主；革兰阳性菌占41.86%，以肺炎链球菌、金黄色葡萄球菌为主；男性患儿流感嗜血杆菌阳性率为15.69%，明显高于女性的11.88%，男性患儿金黄色葡萄球菌阳性率为 11.66%，明显高于女性的 8.67%，差异均有统计学意义(P<0.05)；≤3岁组病原菌总阳性率为66.08%，明显高于>3岁组的14.14%，差异有统计学意义(P<0.05)；春季以流感嗜血杆菌检出率最高，冬季以卡他莫拉菌检出率最高，肺炎链球菌及金黄色葡萄球菌无明显的季节差异(P>0.05)；流感嗜血杆菌对四环素、氧氟沙星、利福平、氯霉素、头孢噻肟耐药率均<5%；肺炎链球菌及金黄色葡萄球菌对利奈唑胺和万古霉素敏感。结论 本地区小儿下呼吸道感染病原菌分布存在性别、年龄、季节差异，临床对儿童下呼吸道感染应进行有针对性的治疗与干预，合理使用抗菌药物。
      【关键词】 下呼吸道感染；痰培养；病原菌；耐药性
      【中图分类号】 R725.6 【文献标识码】 A 【文章编号】 1003—6350（2018）14—1984—04

Distribution and drug resistance of pathogens in 2 639 children with lower respiratory tract infection.
ZHONGXiao-zhen, WEI Jie-hong, MO Hong-mei, ZHANG Xiu-ming. Department of Laboratory Medicine, Shenzhen Luohu DistrictPeople's Hospital, Shenzhen 518001, Guangdong, CHINA
【Abstract】 Objective To analyze the distribution of pathogenic bacteria in children with lower respiratorytract at different gender, age and season in Shenzhen Luohu District People's Hospital and its drug resistance, and to pro-vide guidance for reasonable clinical use of antibiotics. Methods Sputum specimens of 2 639 children with lower respi-ratory tract infection treated in Shenzhen Luohu District People's Hospital from May 2014 to April 2017 were culturedfor identification and drug sensitive test, and the results were statistically analyzed. Results A total of 1 431 strains ofpathogen were isolated, and the detection rate was 54.22%, including 58.14% of Gram-negative bacteria (mainly Hae-mophilus influenzae and Moraxella catarrhalis) and 41.86% of Gram-positive bacteria (mainly Streptococcus pneumoniaeand Staphylococcus aureus). The positive rate of Haemophilus influenzae and Staphylococcus aureus in male children wererespectively 15.69% and 11.66%, which were significantly higher than 11.88% and 8.67% in female children (P<0.05).The positive rate of pathogenic bacteria in≤3 years old children was significantly higher than that of >3 years old chil-·论 著·doi:10.3969/j.issn.1003-6350.2018.14.019基金项目：广东省深圳市医疗卫生三名工程项目(编号：SZSM201601062)