刘娟 王以婷

【摘要】 目的：探讨某院儿科患儿常见病原菌分布特点及其耐药性，为针对性抗菌药物治疗方案的制订提供数据参考。方法：选择2022年11月—2023年2月深圳市龙华区妇幼保健院收集的208例患儿的血液、痰液与粪便样本进行接种、培养与分离，对分离出的235株病原菌进行药敏试验，分析感染疾病患儿的主要病原菌及其对临床常用抗菌药物的耐药性。结果：208例感染疾病患儿血液、痰液及粪便标本中共检出235株病原菌。儿科感染疾病的主要病原菌属于革兰阴性菌，占73.62%（173/235），其中又以流感嗜血杆菌（43.40%）占比最高，其次为卡他莫拉菌（15.32%）与肺炎克雷伯菌（8.94%）。革兰阴性菌中的流感嗜血杆菌对碳青霉烯类抗菌药物无耐药性，对头孢呋辛耐药性最高，为76.47%。卡他莫拉菌对环丙沙星、氨曲南及氨基糖苷类、碳青霉烯类抗菌药物无耐药性，对头孢呋辛耐药性最高，为72.22%。肺炎克雷伯菌对多种头孢类抗菌药物均表现出相对较高的耐药性。革兰阳性菌中的肺炎链球菌对克林霉素耐药性高达100%，而金黄色葡萄球菌对青霉素耐药性为100%。结论：感染疾病患儿病原菌感染以革兰阴性菌为主，且经分离的常见病原菌，如流感嗜血杆菌、卡他莫拉菌、肺炎克雷伯菌、金黄色葡萄球菌等均存在多重耐药现象，流感嗜血杆菌属于导致患兒感染疾病的主要病原菌。

【关键词】 儿科 病原菌 分布特点 耐药性

Distribution Characteristics and Drug Tolerance Analysis of Common Pathogenic Bacteria in 208 Children in Pediatric Department of a Hospital/LIU Juan， WANG Yiting. //Medical Innovation of China， 2024， 21（08）： 0-073

[Abstract] Objective： To investigate the distribution characteristics and drug tolerance analysis of common pathogenic bacteria in children in pediatric department of a hospital， and to provide data reference for the formulation of targeted antimicrobial agent therapy. Method： A total of 208 children's blood， sputum and feces samples collected from Longhua District Maternity & Child Healthcare Hospital from November 2022 to February 2023 were inoculated， cultured and separated. Drug susceptible test were conducted on 235 isolates of pathogenic bacteria， and the main pathogenic bacteria of infectious disease children and their drug tolerance to commonly used clinical antibiotics were analyzed. Result： A total of 235 strains of pathogenic bacteria were detected in the blood， sputum and feces samples of 208 children with infectious diseases. The main pathogenic bacteria of pediatric infectious disease was Gram negative bacterium， accounting for 73.62% （173/235）， among which Haemophilus influenzae （43.40%） accounted for the highest proportion， followed by Moraxella catarrhalis （15.32%） and Klebsiella pneumoniae （8.94%）. Haemophilus influenzae in Gram negative bacterium had no drug tolerance to carbapenems antimicrobial agent， and the drug tolerance to Cefuroxime was the highest， with 76.47%. Moraxella catarrhalis had no drug tolerance to Ciproxacin， Aztreonam and antimicrobial agent of aminoglycoside and carbapenems， and the drug tolerance to Cefuroxime was the highest， with 72.22%. Klebsiella pneumoniae showed relatively high drug tolerance to many kinds of cephalosporin antimicrobial agent. Streptococcal pneumoniae in Gram positive bacterium was up to 100% drug tolerance to Clindamycin， while Staphylococcus aureus was 100% drug tolerance to Penicillin. Conclusion： Gram negative bacterium are the main pathogenic bacteria in children with infectious diseases， and the isolated common pathogenic bacteria， such as Haemophilus influenzae， Moraxella catarrhalis， Klebsiella pneumoniae and Staphylococcus aureus， have multidrug resistant. Haemophilus influenzae is the main pathogenic bacteria that causes children with infectious diseases.

[Key words] Department of pediatrics Pathogenic bacteria Distribution characteristics Drug tolerance

First-author's address： Department of Pediatrics， Longhua District Maternity & Child Healthcare Hospital， Shenzhen 518000， China

doi：10.3969/j.issn.1674-4985.2024.08.016

儿童因为特异性与非特异性免疫功能均处于发育过程中，对病原菌的抵抗能力较为薄弱，因此易发生多类型感染疾病[1]。……