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[目的]了解儿童细菌肺炎患者病原学及药敏试验结果与抗生素使用的情况,为合理使用抗生素提供科学依据。[方法]对2007年2月至2009年11月在岢岚县人民医院内科住院治疗的408例细菌性肺炎患儿的咽部分泌物细菌分离及药敏试验结果与抗生素使用情况进行分析。[结果]采集408例患儿的咽拭子365份,细菌培养阳性的310例,阳性检出率为84.93%,检出341株细菌,其中卡他布兰汉菌112株,四联球菌71株,肺炎球菌64株,链球菌29株,其他细菌65株。常见微生物药敏试验结果,卡他布兰汉氏菌对头孢哌酮钠的耐药率只有7.14%,对氨苄西林纳、青霉素钠的耐药率分别高达75.00%、71.43%;四联球菌对环丙沙星和头孢哌酮钠的耐药率分别高达100.00%、91.55%;肺炎球菌对头孢哌酮钠的耐药率只有9.98%,对青霉素钠的耐药率高达82.81%;链球菌对氨苄西林钠、青霉素钠的耐药率高分别82.16%、72.41%,对头孢哌酮钠和阿米卡星的耐药率只有17.24%。调查408例,入院前75.25%使用过抗生素,其中单种用药的占56.68%,双联用药的占33.55%,三联用药的占6.51%,四联用药的占1.63%,用药情况不详的占1.63%;入院后病原菌不明确情况下96.08%使用2种抗生素;依据分离病原菌药敏试验结果换药者占13.24%。[结论]病原学诊断方法落后于临床需求,报告时间滞后,药敏试验与临床效果一致性差,对临床治疗指导意义较小。
[Objective] To understand the etiological and drug susceptibility test results of children with bacterial pneumonia and the use of antibiotics to provide a scientific basis for rational use of antibiotics. [Method] The bacterial isolation, drug susceptibility test results and antibiotic use of pharyngeal secretions of 408 children with bacterial pneumonia hospitalized in the department of internal medicine of Lanlan County People’s Hospital from February 2007 to November 2009 were analyzed. [Results] Thirty-four throat swabs from 408 children were collected and 310 were positive for bacterial culture. The positive rate was 84.93%. 341 strains of bacteria were detected, of which 112 were Cotranbill, 64 strains of pneumococcus, 29 strains of streptococcus and 65 strains of other bacteria. Common drug susceptibility test results, the rate of resistance to cefoperazone sodium was only 7.14%, and the rates of resistance to ampicillin and penicillin were 75.00% and 71.43%, respectively. The resistant rates of cefoperazone sodium and cefoperazone sodium were as high as 100.00% and 91.55%, respectively. The resistance rate of pneumococcal to cefoperazone sodium was only 9.98%, and the resistance rate to penicillin sodium was as high as 82.81%. Streptococcus was resistant to ampicillin sodium and penicillin sodium The rates were 82.16% and 72.41%, respectively. The resistance rates to cefoperazone sodium and amikacin were only 17.24%. A total of 408 cases were investigated, 75.25% of them used antibiotics before admission, 56.68% were single drug, 33.55% were dual drug, 6.51% were triple drug, 1.63% were quadruple drug and 1.63% were unknown. %; 96.08% of the cases were used antibiotics when the pathogens were not clear; 13.24% of them were drug-replacers according to the drug-susceptibility test results of isolated pathogens. [Conclusion] The etiological diagnosis methods lag behind the clinical needs, the reporting time lag, drug sensitivity test and clinical effect of poor consistency, little significance for clinical treatment.