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目的:了解南宁地区儿童呼吸道感染苛养菌分布及耐药性特点。方法:对2013年8月至2014年7月在广西壮族自治区妇幼保健院住院的呼吸道感染患儿5 235例痰标本苛养菌培养及药敏结果进行回顾分析。结果:5 235例标本共分离出肺炎链球菌226株、流感嗜血杆菌126株、副流感嗜血杆菌34株和卡他布兰汉菌21株。肺炎链球菌对万古霉素均敏感,对喹诺酮类、青霉素、氯霉素、头孢菌素类、酶抑制剂类抗菌药物较敏感,对阿奇霉素、复方磺胺甲唑、红霉素、克林霉素、四环素耐药率超过90%。流感嗜血杆菌、副流感嗜血杆菌、卡他布兰汉菌对头孢噻肟、阿莫西林/克拉维酸、亚胺培南敏感,对氨曲南耐药率均超过60%。流感嗜血杆菌、副流感嗜血杆菌、卡他布兰汉菌产β-内酰胺酶检出率分别为40.48%、38.24%和61.90%(P<0.05)。结论:儿童呼吸道感染苛养菌以肺炎链球菌为主,有其独特耐药谱,临床应明确病原学诊断,根据药敏结果选用敏感抗菌药物。
Objective: To understand the distribution and drug resistance of fastidious bacteria in children with respiratory tract infection in Nanning. Methods: The culture and drug susceptibility tests of 5 235 sputum specimens of sputum from children hospitalized in MCH in Guangxi Zhuang Autonomous Region from August 2013 to July 2014 were retrospectively analyzed. Results: A total of 226 strains of Streptococcus pneumoniae, 126 strains of Haemophilus influenzae, 34 strains of Haemophilus parainfluenzae and 21 strains of Branathan catarrhalis were isolated from 5 235 specimens. Streptococcus pneumoniae are sensitive to vancomycin, quinolones, penicillins, chloramphenicol, cephalosporins, enzyme inhibitors antibacterial drugs are more sensitive to azithromycin, compound sulfamethoxazole, erythromycin, clindamycin , Tetracycline resistance rate of more than 90%. Haemophilus influenzae, Haemophilus parainfluenzae and Branhamella catarrhalis were sensitive to cefotaxime, amoxicillin / clavulanic acid and imipenem, and the rates of resistance to aztreonam were over 60%. Haemophilus influenzae, Haemophilus parainfluenzae and Catarrhyllum were 40.48%, 38.24% and 61.90%, respectively (P <0.05). CONCLUSION: Streptococcus pneumoniae is the predominant bacteria of respiratory tract infection in children. It has its own unique spectrum of drug resistance. It should have a clear etiological diagnosis in clinic and sensitive antibiotics should be selected according to the result of drug sensitivity.