ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2020, Vol. 12 ›› Issue (1): 33-37.doi: 10.3969/j.issn.1674-3865.2020.01.009

• 临床研究 • 上一篇    下一篇

儿童社区获得性肺炎危险因素及病原微生物的药敏特征情况

陈璐，陈艳萍，黄建宝，孟燕妮   

  1. 410007 长沙，湖南省儿童医院呼吸二科
  • 收稿日期:2019-09-05 出版日期:2020-02-25 上线日期:2020-02-25
  • 通讯作者: 陈艳萍，E-mail：hnchengyanping@163.com
  • 作者简介:陈璐（1980-），女，主治医师。研究方向：儿童呼吸系统疾病的诊治

Risk factors and drug sensitivity characteristics of pathogenic microorganisms in children with community acquired pneumonia

CHEN Lu,CHEN Yanping,HUANG Jianbao,MENG Yanni   

  • Received:2019-09-05 Published:2020-02-25 Online:2020-02-25
  • Contact: CHEN Yanping，E-mail：hnchengyanping@163.com

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摘要： 目的 探讨儿童社区获得性肺炎危险因素及病原微生物的药敏特征情况。 方法 选择2018年1月至12月湖南省儿童医院收治的社区获得性肺炎患儿240例为研究对象，为观察组，同时选择在同期内本院门诊健康体检的儿童240例为对照组。首先进行单因素分析，将符合条件的自变量（P<0.05）再纳入多因素Logistic回归分析；同时对观察组儿童痰液或唾液进行细菌培养及药敏实验，分析病原微生物分布情况及药敏特征。 结果 年龄（3～＜6岁）、早产、母乳喂养＜6个月、被动吸烟、先天性疾病、大气污染为儿童社区获得性肺炎危险因素；3个月内母乳喂养、合理饮食、室内装修≥5年为儿童社区获得性肺炎保护因素。观察组240例儿童社区获得性肺炎痰培养出52株病原菌，革兰阳性菌29株（55.8%），以肺炎链球菌12株（23.1%）及金黄色葡萄球菌9株（17.3%）为主，对克林霉素、红霉素、复方新诺明耐药率分别为95.2%（20/21）、90.5%（19/21）、85.7%（18/21），对莫西沙星、万古霉素、头孢类药物较敏感；革兰阴性菌23株（44.2%），以流感嗜血杆菌11株（21.2%）为主，对复方磺胺、头孢克洛、氨苄西林耐药率分别为72.7%（8/11）、63.6%（7/11）、54.5%（6/11），对头孢噻肟、氧氟沙星、氯霉素敏感。 结论 儿童肺炎危险因素与年龄（3～＜6岁）、早产、母乳喂养＜6个月、被动吸烟、先天性疾病、大气污染相关；保护因素与3个月内母乳喂养、合理饮食、室内装修≥5年相关；感染以肺炎链球菌、金黄色葡萄球菌、流感嗜血杆菌为主；沙星类、头孢类药物较敏感。

关键词: 社区获得性肺炎, Logistic分析, 病原微生物, 药敏特征, 儿童

Abstract: Objective To investigate the risk factors and the characteristics of drug sensitivity of pathogenic microorganisms in children with community acquired pneumonia Methods Totally 240 children with community acquired pneumonia were selected as the study group and 240 children who underwent health examination in the same period were selected as the control group  Firstly,according to univariate analysis,risk factors(P<0.05) were included in the multivariate regression analysis At the same time,bacterial culture and drug sensitivity tests were carried out on sputum or saliva of children in the study group to analyze the distribution and drug sensitivity of pathogenic microorganisms Results Age(>3 years old and <6 years old),premature delivery,breastfeeding <6 months,passive smoking,congenital diseases and air pollution were risk factors for community acquired pneumonia in children;breastfeeding within 3 months,reasonable diet,indoor decoration(>5 years) were protective factors  In the study group,52 pathogenic bacteria were isolated from sputum of 240 children with pneumonia,and 29 were Gram positive bacteria(55.8%),mainly Streptococcus pneumoniae(12,23.1%) and Staphylococcus aureus(9,17.3%)  The resistance rates to clindamycin,erythromycin and compound neomycin were 95.2%(20/21),90.5%(19/21),and 85.7%(18/21),respectively  They were more sensitive to moxifloxacin,vancomycin and cephalosporins There were 23 Gramnegative bacteria(44.2%),mainly Haemophilus influenzae(21.2%) The resistance rates to compound sulfonamide,cefaclor and ampicillin were 72.7%(8/11),63.6%(7/11) and 54 5%(6/11),respectively They were sensitive to cefotaxime,ofloxacin and chloramphenicol Conclusion Risk factors of pneumonia in children are related to age (>3,<6 years old),premature delivery,breastfeeding <6 months,passive smoking,congenital diseases and air pollution;protective factors are related to breastfeeding within 3 months,reasonable diet and indoor decoration(>5 years);Streptococcus pneumoniae,Staphylococcus aureus and Haemophilus influenzae are the main bacteria for infections;floxacins and cephalosporins are more sensitive.

Key words: Community acquired pneumonia, Logistic analysis, Pathogenic microorganisms, Drug sensitivity characteristics, Children