Analysis Of Bacterial Pathogen Detection And Drug Resistance In 316 Children With Severe Pneumonia

Objective: To understand the distribution of bacterial etiology and drug resistance in children with severe pneumonia.Methods: Hospitalized children diagnosed with severe pneumonia in our hospital from January 2016 to September 2017 were included in this study.The enroled patients should complete the bacterial pathogen examination of nasopharyngeal aspirate(NPA)and bronchoalveolar lavage fluid(BALF).Bacterial pathogen detection and drug susceptibility results were retrospectively analyzed.Results: A total of 316 children were enrolled,of which 169 cases were infants(53.5%),204(64.6%)with basical disease,and 304(96.2%)with complications.The most common bacteria detection of NPA and BALF were Streptococcus pneumoniae.The resistance rate of Streptococcus pneumoniae to cefotaxime,amoxicillin,meropenem,compound sulfamethoxazole,clindamycin,tetracycline,and erythromycin were 22%,25%,55%,70%,86%,88%,and 98% respectively.The resistance rate of Streptococcus pneumoniae to penicillin was less than20%.And Streptococcus pneumoniae was sensitive to vancomycin,linezolid and rifampine.The bactectial detectection rate of Haemophilus influenzae ranked second in NPA and BALF.The resistance rate of Haemophilus influenzae to amoxicillin clavulanate potassium,cefuroxime,cefaclor,compound sulfamethoxazole,and ampicillin was55%,64%,72%,81%,and 85% respectively.However the sensitivity rate of Haemophilus influenzae to cefotaxime was as high as 80%.Thirteen strains of ESBLs-producing Klebsiella pneumoniae were detected in BALF and 6 strains of ESBLs-producing Klebsiella pneumoniae were detected in NPA.The detection rate of Klebsiella pneumoniae produced by BALF was significantly higher than that of NPA(76.5% vs.37.5%)with statistically significance(P < 0.05).The resisttance rate of Klebsiella pneumoniae to ceftriaxone and cefotaxime was 55% and 60% respectively.The sensitivity rate of Klebsiella pneumoniae to imipenem and piperacillin tazobactam was as high as 80%.Morever,the sensitivity rate of Klebsiella pneumoniae to Luo Peinan was above 90%.Conclusion: The most common bacterial pathogen detected in children with severe pneumonia was Streptococcus pneumoniae,which still showed high sensitivity to penicillin and amoxicillin.Broad-spectrum antibiotic treatment may lead to more frequently detected ESBLs-producing Klebsiella pneumoniae.Appropriate antibiotic use paly an important role in preventing the emergence of resistant strains.