儿科肺炎280例痰培养及药敏分析

李汉煌??冯雪银

[摘要] 目的 分析儿科肺炎常见致病菌特点，以期为肺炎患者的临床治疗及用药提供参考依据。 方法 选取我院2014年1月～2016年12月共280例肺炎患儿作为研究对象，男150例，女130例，年龄1个月～8岁，所有患儿均符合小儿肺炎诊断标准，对280例肺炎患者进行痰标本的采集，进行细菌培养，比较培养菌的阳性率以及药敏结果。 结果 共检测标本280例，检测阳性者230例，阳性率为82.14%。药敏结果主要以阿莫西林、诺氟沙星、头孢西丁、克林霉素以及头孢噻吩等为主，其中阿莫西林敏感率22.17%、耐药率3.91%；诺氟沙星敏感率16.52%、耐药率6.08%；头孢西丁敏感率15.62%、耐药率5.65%；克林霉素敏感率15.21%、耐藥率10.86%；头孢噻吩敏感率13.04%、耐药率5.65%。 结论 临床针对小儿肺炎患者，在进行治疗的过程中，对患儿实际药敏情况及培养菌阳性率等进行了解后，选择合理药物进行治疗，可有效提高患儿免疫力，降低耐药菌株的发生率。

[关键词] 儿科；肺炎；痰培养；药敏分析

[中图分类号] R725.6 [文献标识码] A [文章编号] 2095-0616（2017）12-54-04

Sputum culture and drug sensitivity analysis of 280 cases of pediatric pneumonia

LI Hanhuang FENG Xueyin

Clinical Laboratory，Heyuan Maternal and Child Health-Care Station，Heyuan 517000，China

[Abstract] Objective To analyze the characteristics of common pathogenic bacteria in pediatric pneumonia， so as to provide reference for clinical treatment and medication of pneumonia. Methods A total of 280 children with pneumonia in our hospital from January 2014 to December 2016 were selected as the subjects，including 150 males and 130 females，aged 1 months and ～8 years old.All the children met the diagnostic criteria of pneumonia in children.Sputum samples from 280 patients with pneumonia were collected for bacterial culture，and the positive rates and drug sensitivity of the cultures were compared. Results 280 specimens were detected，of which 230 were positive，with a positive rate of 82.14%.The results of drug sensitivity to amoxicillin，norfloxacin，cefoxitin and clindamycin and cephalothin etc，which amoxicillin sensitive rate was 22.17% and the drug resistance rate of 3.91%.The sensitivity rate of norfloxacin was 16.52% and the resistance rate was 6.08%.Cefoxitin sensitive rate was 15.62%，the resistance rate was 5.65%.Clindamycin sensitivity rate was 15.21%，drug resistance rate was 10.86%.The sensitivity of cefoxitin was 13.04% and the rate of drug resistance was 5.65%. Conclusion In the clinical treatment for children with pneumonia，in the course of treatment，after the the actual drug sensitivity and the positive rate of culture bacteria of children，reasonable drugs for treatment can effectively improve the immunity of children and reduce the incidence of drug-resistant strains.

[Key words] Pediatrics；Pneumonia；Sputum culture；Drug sensitivity analysis

呼吸道感染是儿科临床中常见的病症之一，其中细菌性肺炎的发生率较高，由于儿童的免疫力较差，以及下呼吸道的解剖特点，大多病情较重，病死率高[1]。临床症状主要表现为发热、拒食、烦躁、喘憋等，早期体温一般为38～39℃，严重者会达到40℃，此外，患儿还可能出现精神萎靡、哆嗦、腹泻等全身症状。近年来，随着我国抗菌药物的广泛运用，部分医务工作者未严格遵守相关的操作规范，导致细菌耐药性大幅度上升，有些临床常用药物已经难以对患儿病情进行有效控制[2]。……