Wang Qian-Yu, Li Cong-Rong, Guo Jing, Tang Ke-Wen
Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2019 Dec;21(12):1182-1187. doi: 10.7499/j.issn.1008-8830.2019.12.006.
To study the bacteriologic profile and drug resistance of respiratory infection in children, and to provide a basis for etiological diagnosis and rational use of antimicrobial agents.
A retrospective analysis was performed for 15 047 children who attended the hospital due to respiratory infection from January 2016 to December 2018. Their sputum samples were collected, and the Phoenix-100 automatic microbial identification system was used for the identification and drug sensitivity analysis of the isolated pathogenic bacteria.
Of all 17 174 sputum samples detected, there were 2 395 positive samples, with a positive rate of 13.95%; a total of 2 584 strains of pathogenic bacteria were isolated, among which there were 1 577 (61.03%) Gram-negative strains, 967 (37.42%) Gram-positive strains, and 40 (1.55%) fungal strains. The most common pathogen was Haemophilus influenzae (33.90%), followed by Streptococcus pneumoniae (33.55%), Moraxella catarrhalis (19.20%), and Staphylococcus aureus (3.64%). Among the 2 331 children with positive infection, 251 had mixed infection, most commonly with Haemophilus influenzae and Streptococcus pneumoniae. The detection rate of pathogenic bacteria was higher in winter and spring and lower in summer and autumn. There was a significant difference in the detection rate of pathogenic bacteria between different age groups (P<0.05), with the highest detection rate in infants aged 1 month to <1 year. Streptococcus pneumoniae and Staphylococcus aureus had a sensitivity rate of 100% to vancomycin, linezolid, and teicoplanin, and Haemophilus influenzae had a lower sensitivity rate to ampicillin, compound sulfamethoxazole and cefuroxime and a higher sensitivity rate to other drugs.
Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis are the main pathogenic bacteria of respiratory infection in children, and mixed infection is the most common type of infection. The detection rate of pathogenic bacteria varies across seasons and ages. Different pathogenic bacteria have different features of drug resistance, and antibiotics should be selected based on drug sensitivity results.
研究儿童呼吸道感染的细菌学特征及耐药情况,为病因诊断及合理使用抗菌药物提供依据。
对2016年1月至2018年12月因呼吸道感染住院的15047例儿童进行回顾性分析。采集其痰液样本,采用Phoenix-100全自动微生物鉴定系统对分离出的病原菌进行鉴定及药敏分析。
在检测的17174份痰液样本中,阳性样本2395份,阳性率为13.95%;共分离出病原菌2584株,其中革兰阴性菌1577株(61.03%),革兰阳性菌967株(37.42%),真菌40株(1.55%)。最常见的病原菌是流感嗜血杆菌(33.90%),其次是肺炎链球菌(33.55%)、卡他莫拉菌(19.20%)和金黄色葡萄球菌(3.64%)。在2331例感染阳性儿童中,251例为混合感染,最常见的是流感嗜血杆菌与肺炎链球菌混合感染。病原菌检出率冬春季较高,夏秋季较低。不同年龄组病原菌检出率差异有统计学意义(P<0.05),1月龄至<1岁婴儿检出率最高。肺炎链球菌和金黄色葡萄球菌对万古霉素、利奈唑胺和替考拉宁的敏感率为100%,流感嗜血杆菌对氨苄西林、复方磺胺甲恶唑和头孢呋辛的敏感率较低,对其他药物的敏感率较高。
流感嗜血杆菌、肺炎链球菌和卡他莫拉菌是儿童呼吸道感染的主要病原菌,混合感染是最常见的感染类型。病原菌检出率随季节和年龄而异。不同病原菌有不同的耐药特征,应根据药敏结果选用抗生素。