Pathogen Monitoring And Drug Resistance Analysts Of Children’s Lower Respiratory Tract Infection

As a pediatric common disease, lower respiratory tract infection ofchildren is the first cause of death in children under5years oldworldwide, identifying pathogens of infections and understanding theircharacteristics of drug resistance will play a multiple role in the treatmentof lower respiratory tract infection of children.Objective:Common pathogen surveillance and analysis of pathogendistribution and their drug resistance characteristics, as well as guidanceof clinical therapy can be accomplished through analyzing thehospitalized children with lower respiratory tract infection in a hospital ofChangchun city during2013-2014.Method:1.1219sputum samples of hospitalized children were collectedduring2013-2014,81cases were from Pediatric Surgery,267cases werefrom Pediatric ICU,144cases were from Pediatric Respiratory Section,20cases were from Pediatric Neurology Section,90cases were fromPediatric Nephropathy Section,58cases were from PediatricCardiovascular Section,32cases were from Pediatric HematologySection, and527cases were from Neonatology Department among thesesamples.742cases were male and477cases were female,1294cases ofpathogenic bacteria were isolated after culturing.643cases were≤1yearold baby,284cases were1-3years old early childhood patients,137caseswere4-6years old preschool patients and155cases were7-14school aged patients among these bacteria infectious patients.Results:1.1249positive bacteria strains were isolated after sputum culturewith a total of1219lower respiratory tract infection cases.2.Gram negative bacteria were903strains, accounts for72.3%,which is the most common after analyzing, among these gram-negativebacteria, Klebsiella pneumonia (358strains),Escherichia coli (291strains),Acinetobacter Baumann (172strains) and Pseudomonas aeruginosabacteria (82strains);318gram positive bacteria strains were isolated,which accounts for25.5%of the total, a primary component isStaphylococcus aureus (127strains), the second is Streptococcuspneumonia (92strains), Staphylococcus epidermis (76strains) andenterococci (23strains); Fungi accounts for less proportion (13strains,1%), as Candida albicans (11strains) and tropical candida (2strains) wereisolated.3.Gram-negative bacteria were most sensitive to imipenem, followedby piperacillin/tazobactam and cefoperazone/sulbactam, and wereresistant to cefazolin; Gram-positive bacteria were100%sensitive tovancomycin, and the drug resistance rate to penicillin and erythromycinwere89.7%and66.8%, respectively, followed by52.4%of cefazolin, theresistance rate of ciprofloxacin and levofloxacin were7.5%and9.2%,respectively.Conclusions:1.Pathogens lead to lower respiratory tract of clinical pediatricpatients is increasing, we found that gram-negative bacteria infectionoccupy a large dominant (72.3%) in children with respiratory tractinfection, while gram-positive bacteria only holds25.5%, fungi sharevery little, only1%. 2.Most gram-negative bacteria were sensitive to imipenem, but hasmulti-drug resistance to cefotaxime, ceftriaxone, piperacillin andcotrimoxazole. Gram-positive bacteria were100%sensitive tovancomycin, and has high resistance rate to penicillin, erythromycin andcefazolin.3.This monitoring study suggests that clinicians should not treatingwith antibiotics by arbitrary assume, but on basis of susceptibility resultsand actual condition of pediatric patients, and make proper selection oftargeted anti-infectives, thus, bacteria resistance to antibiotics will bereduced.