In Hospitalized Children With Respiratory Infection Pathogens Surveillance And Drug-resistant Analysis

Objective: In developing children’s metabolism, oxygen demand is high,but the respiratory system is imperfect, the trachea and bronchus is narrow,well developed, the cilia movement is poorer, vital capacity is small, and thebody’s immune function is not yet perfect, low content of SIgA,IgA,IgG, andoferrin, lysozyme, interferon, complement have insufficient number and lessactive, therefore, the incidence of respiratory system infection is higher.Lowerrespiratory infections(LRTIs) of hospitalized children disease first.Commonpathogens include bacteria, viruses and atypical pathogens(mycoplasma,chlamydia, eosinophilic lung legionella bacteria, etc.), fungi and protozoa, etc.Bacterial infections are common. With the change of the environment and thewidespread use of antibiotics, the main pathogenic bacteria is constantlychanging. Some physiological flora in special conditions become pathogenicbacteria, and more resistant to multiple antibiotics. According to our country’sregional difference is big, sanitation inequality between urban and ruraleconomy, also caused the regional different pathogenic bacteria, the principleof the treatment of various bacterial infections are different. Combined withthe scope of pediatric drugs. These are for clinicians and caused greatdifficulties. Understand the region on a regular basis, therefore, children’slower respiratory infection distribution and drug resistance of pathogenicbacteria spectrum, can better guide clinical drug use.Methods: Collection of hebei medical university second hospitalpediatric medical in October2012-October2013hospitalized children (>28days after birth) in492patients with diagnosis of children with respiratorytract infection phlegm (or alveolar lavage) line of bacterial culture and drugsusceptibility test. Results:1In the collection of specimens of492cases of qualified, the positive strains166cases,33.74%detection rate. The gram-negative bacteria (G-) of123cases (74.10%), including e. coli, klebsiella pneumoniae, pseudomonasaeruginosa, acinetobacter baumannii, eosinophilic malt narrow food such asbacterium; Gram-positive bacteria (G+)43cases, accounted for25.90%,including staphylococcus aureus, streptococcus pneumoniae, streptococcusviridans, etc. Infection of pathogenic bacteria is given priority to with G-bacillus.2The main pathogenic bacteria in children’s lower respiratory infection in theage distribution, infants and young children and adolescent group bacteriadetection rate is higher than one preschool and school-age children. On theseason distribution, bacteria detection rate in autumn and winter are relativelyhigh. No significant differences in gender distribution.3.1E. coli sensitive rate was over90%to MeropenemforInjection、Imipenem、 Piperacillin Sodium and Tazobactam Sodium、 amikin、Furadantin.To piperacillin、Ampicillin、Ampicillin Sodium and SulbactamSodium resistant rate of90%above. ESBLs (+) of75%. Klebsiella pneumoniaresistant rate of more than90%to imipenem、meropenemforInjection、piperacillin sodium and tazobactam sodium、cefotetan. To piperacillin andampicillin resistant rate of100.00%. ESBLs (+) of47.37%. Pseudomonasaeruginosa to ampicillin、Furadantin、Cefazolin、Cefotetan、Aztreonamresistant rate of100.00%. To Imipenem、MeropenemforInjection、PiperacillinSodium and Tazobactam Sodium sensitive rate is only60%to70%.Acinetobacter baumannii sensitive drugs only amikacin （91.67%） andlevofloxacin（69.44%）. Have a certain resistance to pediatrics commonly usedantibiotics(Cefuroxime、Cefazolin、cefepime、Aztreonam、Piperacillin Sodiumand Tazobactam Sodium、Piperacillin、Ampicillin Sodium and SulbactamSodium、MeropenemforInjection、Imipenem, etc.).3.2Staphylococcus aureus to Furadantin、 Linezolid、 Quinupristin、Vancomycin、Tigecycline、Teicoplanin、chloroamphenicol、levofloxacinsensitive rate of100.00%.Penicillin resistance is100.00%. MRSA detection rate of42.86%. Streptococcus pneumoniae to Penicillin、Clindamycin、xacillinsensitive rate of100.00%. Of Penicillin、Clindamycin、Oxacillin all resistance.Conclusion:1Children’s lower respiratory infection of pathogenic bacteria is givenpriority to with G-bacteria, different bacterial have different resistance toantibiotics.2E. coli and klebsiella pneumonia bacteria still only to Meropenem-forInjection、Imipenem、Piperacillin Sodium and Tazobactam Sodium havehigher sensitivity.The unfermentation bacteria multi-resistant more serious.G+cocci to Vancomycin、Linezolid、Teicoplanin was high sensitivity, toBenzathine、Clindamycin、Oxacillin was resistance.3The main pathogenic bacteria in children’s lower respiratory infectionare differences in onset age,and seasonal distribution, has no obviousdifference in gender distribution.4Understanding of children’s lower respiratory infection pathogenicbacteria distribution and drug resistance, and the gender, age, seasondifferences, have important guiding significance to guide the clinicalmedication, the rational use of antibiotics, reducing the generation ofdrug-resistant strains.