Pathogens and Antibiotic Resistance of Community-Acquired Pneumonia in Children Aged Under 5 Years Old in Lanzhou

doi:10.3877/cma.j.issn.1673-5250.2012.01.007

Objective

To investigate the pathogens and antibiotic resistance of community-acquired pneumonia (CAP) in children aged under 5 years old in Lanzhou.

Methods

A total of 610 CAP cases of hospitalized children in the Department of Pediatrics, Lanzhou University Second Hospital from August 2008 to August 2010 were included in this study. Actualized sputum culture, test of drug sensitivity and statistical analysis were conduct.

Results

In the 610 cases, 211 specific pathogens were identified in 197 cases (32.3%). It included 127 cases (60.2%) of Gram-negative (G^-) bacteria and 84 (39.8%) of Gram-positive (G⁺ ) bacteria. Among them, the main bacteria were Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, Enterobacter cloacae and Streptococcus pneumoniae Coli. Drug resistance of the main G^- bacilli to ampicillin, piperacillin, second and third generation cephalosporin were particularly common, while imipenem and amikacin presented high sensitivity. For the G⁺ cocci, penicillin, penbritin and erythromycin had high drug resistance rate, but vancomycin, quinupristin and linezolid showed 100.0% sensitivity.

Conclusions

The dominant pathogens during the recent two years in this region for the hospitalized children with CAP is G^- bacilli, and it showed the high drug resistance rate.

Key words: child, community-acquired pneumonia, pathogen, susceptibility

表1 610例儿童社区获得性肺炎病原菌种类及构成比(%)

Table 1 Pathogen types and constituent ratios among 610 samples of community－acquired pneumonia (%)

病原菌		n(株)	构成比
G^－菌		127	60.2
?	大肠埃希菌	47	22.3
?	肺炎克雷伯菌	21	10.0
?	阴沟肠杆菌	20	9.5
?	铜绿假单胞菌	10	4.7
?	嗜血杆菌	7	3.3
?	其他G^－菌	22	10.4
G^＋菌		84	39.8
?	金黄色葡萄球菌	38	18.0
?	其他葡萄球菌	24	11.4
?	链球菌	20	9.5
?	屎肠球菌	2	0.9
合计		211	100.0

表1 610例儿童社区获得性肺炎病原菌种类及构成比(%)

Table 1 Pathogen types and constituent ratios among 610 samples of community－acquired pneumonia (%)

病原菌		n(株)	构成比
G^－菌		127	60.2
?	大肠埃希菌	47	22.3
?	肺炎克雷伯菌	21	10.0
?	阴沟肠杆菌	20	9.5
?	铜绿假单胞菌	10	4.7
?	嗜血杆菌	7	3.3
?	其他G^－菌	22	10.4
G^＋菌		84	39.8
?	金黄色葡萄球菌	38	18.0
?	其他葡萄球菌	24	11.4
?	链球菌	20	9.5
?	屎肠球菌	2	0.9
合计		211	100.0

表2 前3位革兰阴性菌的耐药率比较(%)

Table 2 Comparison of drug resistance rates of the main Gram negative bacteria(top three)(%)

抗菌药物	大肠埃希菌(n＝47)	肺炎克雷伯菌(n＝21)	阴沟肠杆菌(n＝20)
哌拉西林	85.1	71.4	55.0
哌拉西林他唑巴坦	6.4	9.5	25.0
氨苄青霉素	85.1	85.7	95.0
阿米卡星	4.3	4.8	10.0
阿莫西林/棒酸	4.3	14.3	100.0
环丙沙星	42.6	28.6	15.0
头孢唑林	66.0	66.7	100.0
头孢吡肟	63.8	66.7	30.0
头孢他啶	57.4	66.7	35.0
头孢西丁	2.1	0.0	85.0
头孢曲松	76.6	80.9	55.0
头孢噻肟	76.6	76.2	50.0
妥布霉素	31.9	23.8	25.0
庆大霉素	46.8	61.9	25.0
亚胺培南	0.0	0.0	0.0
左氧氟沙星	40.4	19.0	10.0

表2 前3位革兰阴性菌的耐药率比较(%)

Table 2 Comparison of drug resistance rates of the main Gram negative bacteria(top three)(%)

抗菌药物	大肠埃希菌(n＝47)	肺炎克雷伯菌(n＝21)	阴沟肠杆菌(n＝20)
哌拉西林	85.1	71.4	55.0
哌拉西林他唑巴坦	6.4	9.5	25.0
氨苄青霉素	85.1	85.7	95.0
阿米卡星	4.3	4.8	10.0
阿莫西林/棒酸	4.3	14.3	100.0
环丙沙星	42.6	28.6	15.0
头孢唑林	66.0	66.7	100.0
头孢吡肟	63.8	66.7	30.0
头孢他啶	57.4	66.7	35.0
头孢西丁	2.1	0.0	85.0
头孢曲松	76.6	80.9	55.0
头孢噻肟	76.6	76.2	50.0
妥布霉素	31.9	23.8	25.0
庆大霉素	46.8	61.9	25.0
亚胺培南	0.0	0.0	0.0
左氧氟沙星	40.4	19.0	10.0

表3 前3位革兰阳性球菌对常见抗菌药物的耐药率(%)

Table 3 Comparison of drug resistance rate of the mainly Gram positive bacteria(top three)(%)

抗菌药物抗生素	MRSA(n＝38)	其他葡萄球菌(n＝24)	链球菌(n＝20)
哌拉西林他唑巴坦	7.9	－	－
氨苄青霉素	88.9	100.0	－
阿莫西林/棒酸	18.4	83.3	－
环丙沙星	0.0	41.7	－
头孢唑林	18.4	87.5	－
四环素	47.4	16.7	45.0
红霉素	57.9	91.7	75.0
青霉素	89.5	100.0	35.0
庆大霉素	7.9	33.3	－
亚胺培南	15.8	83.3	－
左氧氟沙星	5.3	33.3	0.0
克林霉素	42.1	58.3	55.0
奎奴普汀	0.0	0.0	0.0
万古霉素	0.0	0.0	0.0
利奈唑胺	0.0	0.0	0.0

表3 前3位革兰阳性球菌对常见抗菌药物的耐药率(%)

Table 3 Comparison of drug resistance rate of the mainly Gram positive bacteria(top three)(%)

抗菌药物抗生素	MRSA(n＝38)	其他葡萄球菌(n＝24)	链球菌(n＝20)
哌拉西林他唑巴坦	7.9	－	－
氨苄青霉素	88.9	100.0	－
阿莫西林/棒酸	18.4	83.3	－
环丙沙星	0.0	41.7	－
头孢唑林	18.4	87.5	－
四环素	47.4	16.7	45.0
红霉素	57.9	91.7	75.0
青霉素	89.5	100.0	35.0
庆大霉素	7.9	33.3	－
亚胺培南	15.8	83.3	－
左氧氟沙星	5.3	33.3	0.0
克林霉素	42.1	58.3	55.0
奎奴普汀	0.0	0.0	0.0
万古霉素	0.0	0.0	0.0
利奈唑胺	0.0	0.0	0.0

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