Analysis of pathogen distribution and drug resistance of 469 children with severe bacterial pneumonia in our hospital
LI Li1 WANG Fei-ling2 KONG Cheng-xiang1▲ JIN Ping1 WU Li-juan2 XIE Hong-bo1
1.Department of Pediatrics, Maternal and Child Health Care Hospital of Bao′an District in Shenzhen City Affiliated to Jinan University, Guangdong Province, Shenzhen 518106, China;
2.Clinical Laboratory, Maternal and Child Health Care Hospital of Bao′an District in Shenzhen City Affiliated to Jinan University, Guangdong Province, Shenzhen 518106, China
Abstract：Objective To analyze the distribution and drug resistance of pathogens in children with severe bacterial pneumonia, and to provide evidence for rational selection of antibiotics in clinic.Methods The data of 469 children with severe pneumonia admitted to PICU in our hospital from June 2013 to June 2018 were retrospectively analyzed.The sputum or alveolar lavage fluid of all the patients were collected for bacterial culture, bacterial identification and drug sensitivity analysis were performed on positive samples.Results Among the 469 sputum or alveolar lavage fluid samples, 298 cases showed positive bacterial culture.The pathogenic bacteria included gram-positive bacteria (G＋) and gram-negative bacteria (G－).G＋had 126 cases, accounted for 42.28%, with the first three bacteria were Streptococcus pneumonia (86/298, 28.86%), Staphylococcus aureus (39/298, 13.09%), Enterococcus faecalis (1/298, 0.34%).G－ had 172 cases, accounted for 57.72%, mainly including Haemophilus influenzae (71/298, 23.83 %), Klebsiella pneumoniae(22/298, 7.38%), Escherichia coli (20/298, 6.71%), Acinetobacter baumannii (15/298, 5.03%), Pseudomonas aeruginosa(10/298, 3.36%).This study showed that the pathogens of children with severe bacterial pneumonia were mainly G－.The detection rate of ESBLs-producing Escherichia coli was 65.00% (13/20), the detection rate of Klebsiella pneumoniae producing ESBLs was 45.45% (10/22), me-thicillin-resistant Staphylococcus aureus (MRSA) was 17.95% (7/39).The first two G＋bacteria detected were Streptococcus pneumoniae and Staphylococcus aureus, the resistance rates of to Vancomycin and Linezolidf both of them were 0, it was resistant to Erythromycin, Clindamycin and Tetracycline.The resistance rate of Staphylococcus aureus to Penicillin, second-generation and third-generation cephalosporins was higher than that of Streptococcus pneumonia.Streptococcus pneumoniae also showed high resistance to Cotrimoxazole.The top five G－ were resistant to commonly used clinical antibiotics in varying degrees, and some bacteria showed multiple drug resistance.Conclusion The pathogen spectrum of severe pneumonia in children is undergoing new changes.According to the data of bacterial epidemiology and the characteristics of drug sensitivity in this area, combined with the clinical reality of children, rational selection of effective antibiotics for treatment can significantly improve the success rate of treatment of severe pneumonia in children and reduce the bacterial resistance.
李莉； 王飞玲； 孔程祥； 金萍； 吴丽娟； 谢红波. 我院469例儿童细菌性重症肺炎的病原菌分布及耐药性分析[J]. 中国当代医药, 2019, 26(14): 117-120转127.
LI Li； WANG Fei-ling； KONG Cheng-xiang； JIN Ping； WU Li-juan； XIE Hong-bo. Analysis of pathogen distribution and drug resistance of 469 children with severe bacterial pneumonia in our hospital. 中国当代医药, 2019, 26(14): 117-120转127.
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