内科

目的分析呼吸系统疾病患儿的病原菌分布和耐药情况，为指导临床合理使用抗菌药物提供参考。方法对2019～2020年广西某医院新生儿/儿科收治的呼吸系统疾病患儿的3 557份样本进行病原菌培养、细菌鉴定及药敏试验。结果3 557份样本中共检出病原菌1 056株，其中数量较多的为肺炎链球菌、大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、卡他莫拉菌、凝固酶阴性葡萄球菌、流感嗜血杆菌。共检出葡萄球菌属126株，其中凝固酶阴性葡萄球菌和金黄色葡萄球菌对青霉素耐药率分别为89.7%和92.6%，对苯唑西林的耐药率分别为77.6%和57.4%；共检出革兰阴性杆菌314 株，其中大肠埃希菌对氨苄西林、氨苄西林/舒巴坦、环丙沙星的耐药率分别为63.0%、35.9%和33.7%，肺炎克雷伯菌对氨苄西林、氨苄西林/舒巴坦的耐药率分别为100%和38.7%；共检出社区获得性感染病原菌251株，其中肺炎链球菌对红霉素、克林霉素、四环素、复方新诺明的耐药率分别为94.8%、85.2%、81.5%和76.3%，卡他莫拉菌对氨苄西林耐药率为100%，流感嗜血杆菌对复方新诺明、氨苄西林、阿莫西林/克拉维酸钾的耐药率分别为79.6%、71.4%和71.4%。结论儿童呼吸系统疾病的病原菌谱以及耐药性不断发生变化，对其进行监测可很好地指导临床医师合理选用抗菌药物进行治疗，从而获得良好的治疗效果，减少耐药情况的发生。

ObjectiveTo analyze the pathogen distribution and drug resistance of respiratory diseases in children, and to provide a reference for guiding clinical rational use of antibiotics. MethodA total of 3557 samples of children with respiratory diseases admitted to the Neonatal/Pediatrics Department of a hospital in Guangxi from 2019 to 2020 were conducted to pathogen culture, bacterial identification and drug susceptibility tests. ResultsThere were a total of 1056 pathogen strains in 3557 tested samples, among which streptococcus pneumoniae, escherichia coli, klebsiella pneumoniae, staphylococcus aureus, Moraxella catarrhalis, coagulase-negative staphylococcus, and Haemophilus influenzae accounted for a relatively high proportion. A total of 126 strains of staphylococcus were detected, among which the drug resistance rates of coagulase-negative staphylococcus and staphylococcus aureus to penicillin were 89.7% and 92.6%, respectively, and the rates to oxacillin were 77.6% and 57.4%, respectively. A total of 314 strains of gram-negative bacilli were detected, of which the drug resistance rates of escherichia coli to ampicillin, ampicillin/sulbactam, and ciprofloxacin were 63.0%, 35.9% and 33.7%, respectively, whereas the rates of Klebsiella pneumoniae to ampicillin and ampicillin/sulbactam were 100% and 38.7%, respectively. A total of 251 strains of community-acquired infection pathogen were detected, among them, the drug resistance rates of Streptococcus pneumoniae to erythromycin, clindamycin, tetracycline and compound sulfamethoxazole were 94.8%, 85.2%, 81.5% and 76.3%, respectively, whereas the rate of Moraxella catarrhalis to ampicillin was 100%, as well as the rates of Haemophilus influenzae to compound sulfamethoxazole, ampicillin, and amoxicillin/clavulanate potassium were 79.6%, 71.4% and 71.4%, respectively. ConclusionThe pathogen spectrum and drug resistance of respiratory diseases in children change constantly, monitoring them can commendably guide clinicians to rationally choose antibiotics for treatment, and thus obtain favourable therapeutic effects, reduce the occurrence of drug resistance.