目的 了解儿童呼吸道感染的病原菌种类、分布特点和耐药情况，为临床提供病原学诊断及合理使用抗菌药物的依据。方法 选取2016年1月至2018年12月因呼吸道感染就诊的15 047例患儿为研究对象，采集患儿痰标本送检，通过Phoenix-100全自动微生物鉴定药敏系统对分离的病原菌进行鉴定和药敏分析。结果 从17 174份送检的痰标本中检出阳性标本2 395份，阳性率为13.95%；共分离出2 584株病原菌，其中革兰阴性菌1 577株（61.03%），革兰阳性菌967株（37.42%），真菌40株（1.55%）。最常见的病原菌依次为流感嗜血杆菌（33.90%）、肺炎链球菌（33.55%）、卡他莫拉菌（19.20%）和金黄色葡萄球菌（3.64%）。2 331例感染阳性患儿中有251例混合感染，以流感嗜血杆菌合并肺炎链球菌感染发生率最高。病原菌检出率以冬春季较高，夏秋季较低（P < 0.05）。各年龄组患儿病原菌检出率比较差异有统计学意义（P < 0.05），其中1个月~ < 1岁组患儿病原菌检出率最高。肺炎链球菌和金黄色葡萄球菌对万古霉素、利奈唑胺和替考拉宁敏感率均为100%，流感嗜血杆菌除对氨苄西林、复方新诺明和头孢呋辛敏感率较低，对其他药物敏感率均较高。结论 儿童呼吸道感染病原菌以流感嗜血杆菌、肺炎链球菌和卡他莫拉菌为主，且常见混合型感染。不同季节、不同年龄段病原菌检出率不同。不同病原菌耐药性有不同特点，临床应依据药敏结果合理选用抗生素。

Objective To study the bacteriologic profile and drug resistance of respiratory infection in children, and to provide a basis for etiological diagnosis and rational use of antimicrobial agents. Methods A retrospective analysis was performed for 15 047 children who attended the hospital due to respiratory infection from January 2016 to December 2018. Their sputum samples were collected, and the Phoenix-100 automatic microbial identification system was used for the identification and drug sensitivity analysis of the isolated pathogenic bacteria. Results Of all 17 174 sputum samples detected, there were 2 395 positive samples, with a positive rate of 13.95%; a total of 2 584 strains of pathogenic bacteria were isolated, among which there were 1 577 (61.03%) Gram-negative strains, 967 (37.42%) Gram-positive strains, and 40 (1.55%) fungal strains. The most common pathogen was Haemophilus influenzae (33.90%), followed by Streptococcus pneumoniae (33.55%), Moraxella catarrhalis (19.20%), and Staphylococcus aureus (3.64%). Among the 2 331 children with positive infection, 251 had mixed infection, most commonly with Haemophilus influenzae and Streptococcus pneumoniae. The detection rate of pathogenic bacteria was higher in winter and spring and lower in summer and autumn. There was a significant difference in the detection rate of pathogenic bacteria between different age groups (P < 0.05), with the highest detection rate in infants aged 1 month to <1 year. Streptococcus pneumoniae and Staphylococcus aureus had a sensitivity rate of 100% to vancomycin, linezolid, and teicoplanin, and Haemophilus influenzae had a lower sensitivity rate to ampicillin, compound sulfamethoxazole and cefuroxime and a higher sensitivity rate to other drugs. Conclusions Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis are the main pathogenic bacteria of respiratory infection in children, and mixed infection is the most common type of infection. The detection rate of pathogenic bacteria varies across seasons and ages. Different pathogenic bacteria have different features of drug resistance, and antibiotics should be selected based on drug sensitivity results.