
Bacteriologic profile and drug resistance in children with respiratory infection from 2016 to 2018
WANG Qian-Yu, LI Cong-Rong, GUO Jing, TANG Ke-Wen
Chinese Journal of Contemporary Pediatrics ›› 2019, Vol. 21 ›› Issue (12) : 1182-1187.
Bacteriologic profile and drug resistance in children with respiratory infection from 2016 to 2018
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.
Respiratory infection / Pathogenic bacteria / Drug resistance / Child
[1] Liu L, Johnson HL, Cousens S, et al. Global, regional, and national causes of child mortality:an updated systematic analysis for 2010 with time trends since 2000[J]. Lancet, 2012, 379(9832):2151-2161.
[2] UNICEF, WHO, World Bank, et al. Levels and trends in child mortality 2014[EB/OL]. (2014). https://www.who.int/maternal_child_adolescent/documents/levels_trends_child_mortality_2014/en/.
[3] 季伟, 陈正荣, 周卫芳, 等. 2005-2011年苏州地区急性呼吸道感染住院儿童病原学研究[J]. 中华预防医学杂志, 2013, 47(6):497-503.
[4] Clinical and Laboratory Standards Institute. Performance Standards for antimicrobial susceptibility testing:twenty-sixth informational supplement[S]. CLSI document M100-S26. Wayne, PA:Clinical and Laboratory Standards Institute. 2016.
[5] Clinical and Laboratory Standards Institute. Performance Standards for antimicrobial susceptibility testing:twenty-seventh informational supplement[S]. CLSI document M100-S27. Wayne, PA:Clinical and Laboratory Standards Institute. 2017.
[6] Clinical and Laboratory Standards Institute. Performance Standards for antimicrobial susceptibility testing:twenty-eighth informational supplement[S]. CLSI document M100-S28. Wayne, PA:Clinical and Laboratory Standards Institute. 2018.
[7] 王淑会, 季伟, 张新星, 等. 苏州地区14994例儿童呼吸道感染细菌病原学特点[J]. 中国当代儿科杂志, 2016, 18(1):44-50.
[8] 王丽萍, 邵春红, 范会, 等. 某院2013-2016年儿童呼吸道感染病原菌分布及耐药性分析[J]. 检验医学与临床, 2018, 15(11):1537-1541.
[9] 蔡晓华, 单红霞, 张品忠. 儿童急性下呼吸道感染病原菌分布及耐药性监测[J]. 中华医院感染学杂志, 2014, 24(12):3075-3076.
[10] 汪玲娟, 王明欢, 龚方彪, 等. 儿童呼吸道感染的病原菌分布与耐药性特点及血清相关免疫指标变化研究[J]. 中华医院感染学杂志, 2018, 28(6):939-942.
[11] 黄蓉, 黄梁镔, 田应敏, 等. 连续3年儿科住院患者痰分离病原菌及耐药性变迁[J]. 中国感染控制杂志, 2015, 14(4):236-239.
[12] 李晓松, 张学军, 张凌凌, 等. 肺炎患者痰细菌学标本采集时机对痰细菌学检验结果的影响比较[J]. 医学检验与临床, 2017, 28(3):61-62, 31.
[13] 胡亚美, 江载芳. 诸福棠实用儿科学[M]. 第7版. 北京:人民卫生出版社, 2002, 921:1143-1190.
[14] Deng JC. Viral-bacterial interactions-therapeutic implications[J]. Influenza Other Respir Viruses, 2013, 7(Suppl 3):24-35.
[15] Ortqvist A, Hedlund J, Kalin M. Streptococcus pneumoniae:epidemiology, risk factors, and clinical features[J]. Semin Respir Crit Care Med, 2005, 26(6):563-574.
[16] 高林. 氯霉素的不良反应及其残留检测方法研究进展[J]. 动物医学进展, 2010, 31(4):90-95.
[17] 谷丽. 慎用喹诺酮类药物经验性治疗社区获得性肺炎[J]. 中国医刊, 2011, 46(10):5-6.