儿童社区获得性肺炎病原体分布与临床用药分析
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摘要
目的探讨儿童社区获得性肺炎(CAP)病原体分布和治疗情况。方法采用回顾性分析方式,选取2016年4月～2018年4月来自金城江区在本院住院的社区获得性肺炎儿童300例作为研究对象,分析其病原体分布特点和抗菌素使用情况。结果 300例CAP患儿中阳性患儿251例,阳性率为83.7%,其中单纯性细菌感染患儿占33.1%(83/251);单纯性病毒感染率21.3%(58/251);单纯性支原体感染率为21.5%(54/251);单纯性衣原体感染率为2.4%(6/251);混合感染率为22.3%(56/251)。4种主要细菌病原体:肺炎链球菌、金黄色葡萄球菌、肺炎克雷伯菌、大肠埃希菌,这些病原体具有较高的耐药性;抗菌药物中青霉素、红霉素敏感性最强,头孢呋辛、哌拉西林舒巴坦敏感性为中介,对亚胺培南、万古霉素能保持良好的敏感性。结论该地区社区获得性肺炎病原体主要以细菌感染为主,选择合适的抗生素能有效提高治疗效果。
Objective To investigate the distribution and treatment of community acquired pneumonia(CAP) pathogens in Jinchengjiang District.Methods A retrospective analysis was conducted to select 300 children with CAP from April 2016 to April 1818. The distribution characteristics of pathogens and the use of antibiotics were analyzed.Results Of the 300 children with CAP,251 were positive for pathogens,accounting for 83.7%,of which 83 were simple bacterial infections,accounting for 33.1% of the positive results;58 were simple viral infections,accounting for 21.3%;54 cases For simple mycoplasma infection, accounted for 21.5%; 6 cases were simple chlamydia infection,accounting for 2.4%;56 cases were mixed infection,accounting for 22.3%.The four major bacterial pathogens,Streptococcus pneumoniae,Staphylococcus aureus,Klebsiella pneumoniae,and Escherichia coli,have certain resistance to most antibacterial drugs,among which penicillin and erythromycin are the most obvious,and cefuroxime,Piperacillin sulbactam sensitivity as a mediator, can maintain good sensitivity to imipenem,vancomycin.Conclusion The pathogens of community-acquired pneumonia in this area are mainly bacterial infections.Choosing appropriate antibiotics can effectively improve the therapeutic effect.
Objective To investigate the distribution and treatment of community acquired pneumonia(CAP) pathogens in Jinchengjiang District.Methods A retrospective analysis was conducted to select 300 children with CAP from April 2016 to April 1818. The distribution characteristics of pathogens and the use of antibiotics were analyzed.Results Of the 300 children with CAP,251 were positive for pathogens,accounting for 83.7%,of which 83 were simple bacterial infections,accounting for 33.1% of the positive results;58 were simple viral infections,accounting for 21.3%;54 cases For simple mycoplasma infection, accounted for 21.5%; 6 cases were simple chlamydia infection,accounting for 2.4%;56 cases were mixed infection,accounting for 22.3%.The four major bacterial pathogens,Streptococcus pneumoniae,Staphylococcus aureus,Klebsiella pneumoniae,and Escherichia coli,have certain resistance to most antibacterial drugs,among which penicillin and erythromycin are the most obvious,and cefuroxime,Piperacillin sulbactam sensitivity as a mediator, can maintain good sensitivity to imipenem,vancomycin.Conclusion The pathogens of community-acquired pneumonia in this area are mainly bacterial infections.Choosing appropriate antibiotics can effectively improve the therapeutic effect.
引文
[1]蒋露晰,任红宇,周海健,等.社区获得性肺炎病原体检测方法研究进展[J].中华流行病学杂志,2016,(7):1051-1054.
[2]李雅杰,张全新,李锋,等.唐山市区社区获得性肺炎患儿病原体分布及其耐药性分析[J].检验医学与临床,2018,(9):1278-1280.
[3]夏厚才,罗小兵,马瑞红,等.儿童社区获得性肺炎病原体分布及细菌耐药性分析[J].国际检验医学杂志,2017,(5):687-689.
[4]邱玉泉,林梅芳.新生儿社区获得性肺炎病原体分布及药敏分析[J].中国现代医生,2017,(15):63-65,69.
[5]邓紫薇,仇成凤,李茂作,等.成人社区获得性肺炎主要病原体分布的Meta分析[J].中国抗生素杂志,2016,(12):950-955.
[6]李双飞,马佳,徐丽惠.150例社区获得性肺炎病原体分布及耐药性分析[J].中国药物经济学,2015,(z1):215-217.
[7]李芳,张锦.社区获得性肺炎病原体的构成谱及耐药现状[J].宁夏医学院学报,2008,(2):256-259.
[8]黄娴,朱祥,王军,等.2013-2016年苏州工业园区成人社区获得性肺炎非典型病原体研究[J].临床合理用药杂志,2017,(32):166-167.
[2]李雅杰,张全新,李锋,等.唐山市区社区获得性肺炎患儿病原体分布及其耐药性分析[J].检验医学与临床,2018,(9):1278-1280.
[3]夏厚才,罗小兵,马瑞红,等.儿童社区获得性肺炎病原体分布及细菌耐药性分析[J].国际检验医学杂志,2017,(5):687-689.
[4]邱玉泉,林梅芳.新生儿社区获得性肺炎病原体分布及药敏分析[J].中国现代医生,2017,(15):63-65,69.
[5]邓紫薇,仇成凤,李茂作,等.成人社区获得性肺炎主要病原体分布的Meta分析[J].中国抗生素杂志,2016,(12):950-955.
[6]李双飞,马佳,徐丽惠.150例社区获得性肺炎病原体分布及耐药性分析[J].中国药物经济学,2015,(z1):215-217.
[7]李芳,张锦.社区获得性肺炎病原体的构成谱及耐药现状[J].宁夏医学院学报,2008,(2):256-259.
[8]黄娴,朱祥,王军,等.2013-2016年苏州工业园区成人社区获得性肺炎非典型病原体研究[J].临床合理用药杂志,2017,(32):166-167.