儿童支气管肺炎革兰阴性菌耐药监测分析

Antibiotic resistance of gram-negative Bacillis isolated from children with bronchopneumonia

摘要:

目的：监测儿童支气管肺炎革兰阴性菌分布及耐药情况，为临床合理用药提供依据。方法：对2009年分离于支气管肺炎患儿痰液的272株革兰阴性致病菌分布及药敏试验数据进行统计、分析。结果：分离菌株中，以肺炎克雷伯菌、大肠埃希菌为主，产超广谱β-内酰胺酶（ESBLs）菌占52.9%。除美罗培南及阿米卡星以外，产ESBLs菌株对其他抗菌药物的耐药率高于非产ESBLs的菌株，差异有统计学意义（P<0.05）。产ESBLs的革兰阴性菌株对美罗培南的耐药率最低，仅为0.7%，其次为亚胺培南、阿米卡星、头孢哌酮/舒巴坦。结论：应高度重视儿科较高的产ESBLs菌株的检出率及耐药率，根据耐药监测结果合理应用抗菌药物。

Abstract:

OBJECTIVE: To study the distribution and antibiotic resistance of gram-negative pathogens isolated from children with bronchopneumonia. METHODS: The distribution and the results of susceptibility tests of 272 strains of gram-negative Bacillis isolated from children with bronchopneumonia during 2009 were analyzed. RESULTS: Among the isolates, the common pathogens were Klebsiella pneumoniae and Escherichia coli. The extended-spectrum β-lactamase (ESBLs) production rate was 52.9%. Compared with the non-ESBLs producing strains, ESBLs-producing strains had a significantly higher drug resistance rate to many antibiotics except amikacin and meropenem (P<0.05). The lowest resistance to ESBLs producing gram negative strains was found for meropenem (0.7%), followed by imipenem, amikacin and cefoperazone/sulbactam. CONCLUSIONS: More attentions should be paid to the high rate of drug-resistance of ESBLs producing strains in children. Antimicrobial therapy should be based on the results of drug resistance surveillance.