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苏州地区2013-2018年肺炎住院患儿肺泡灌洗液的病原菌分布及耐药特征分析

  

  1. 苏州大学附属儿童医院 检验科,  江苏 苏州 215003
  • 出版日期:2019-09-20 发布日期:2019-11-19
  • 通讯作者: 计雪强,Email:hpsz_2005@126.com

Distribution and drug resistance characteristics of bronchoalveolar lavage fluid in hospitalized children with pneumonia in Soochow 2013-2018

  1. Department of Clinical Laboratory,  the Children Hospital Affiliated to Soochow University,  Suzhou 215003,  China
  • Online:2019-09-20 Published:2019-11-19
  • Contact: Corresponding author: Ji Xueqiang, Email: hpsz_2005@126.com

摘要: 目的  通过回顾性的分析2013-2018年苏州地区肺炎住院患儿肺泡灌洗液(BALF)的病原菌分布及耐药变迁的特征分析,为合理使用抗菌药物有效控制相关感染提供依据。方法  2013年1月至2018年12月我院的肺炎住院患儿因诊治的需要抽取BALF,进行病原菌的检测。结果  收集到BALF标本3 242份,共分离出病原菌418份。病原菌分离阳性率为12.89%。主要菌种为肺炎链球菌和流感嗜血杆菌,检出率分别为38.28%和21.05%。肺炎链球菌对对红霉素、复方新诺明、克林霉素和四环素明显耐药,耐药率无明显改变(P>0.05)。流感嗜血杆菌对头孢曲松、美洛培南和头孢他叮高度敏感,对氨卞西林耐药率逐年增高(P<0.05)。β内酰胺酶的阳性率也明显增加(P<0.05)。结论  对治疗困难及无法获得明确病原学资料的难治性肺炎及小年龄的肺炎患儿可进行BALF病原学检测。苏州地区BALF病原菌分布和耐药率变化有自身特征,应加强耐药监测和分析,根据儿童用药特点,指导临床合理用药。

关键词: 肺炎,  , 细菌性, 支气管肺泡灌洗液, 儿童

Abstract: Objective  The distribution of pathogenic bacteria and characteristics of drug resistance changes of bronchoalveolar lavage in hospitalized  children with pneumonia in Suzhou  2013 to 2018 were retrospectively analyzed,  to provide a basis for the rational use of antimicrobial agents to effectively control related infections. Methods  For the children with pneumonia who were hospitalized from January 2013 to December 2018,  bronchoalveolar lavage(BALF) was extracted to detect the pathogen for the need of diagnosis and treatment.Results  A  total of 3 242 BALF samples were collected,  from which 418 samples of pathogens were isolated.The positive rate of pathogen isolation was 12.89%. The main strains were Streptococcus pneumoniae and Haemophilus influenzae,  with the detection rates of  38.28%  and  21.05%,  respectively. Streptococcus pneumoniae was significantly resistant to erythromycin,  compound neostigmine,  clindamycin and tetracycline,  and the drug resistance rate was not significantly changed (P>0.05). Haemophilus influenzae was highly sensitive to ceftriaxone,  metopenan and ceftapexin,  and the drug resistance rate to ampicillin increased yearly (P<0.05).The positive rate of βlactamase was also significantly increased (P<0.05).Conclusion  BALF etiological test can be used to detect children with pneumonia at a young agebecause of the refractory pneumonia with treatment difficulties and no clear etiological data.The distribution and drug resistance rate of  BALF pathogenin Soochow have their own characteristics,  so drug resistance monitoring and analysis should be strengthened. The clinical rational drug use should be duided according to the characteristics of the drug use in children.

Key words: pneumonia, , bacterial, bronchoalveolar lavage fluid, children