Abstract: 【Objective】 To provide reference for the treatment for clinicians during the recent two years investigation of bacterial and antibiotic resistance analysis of hospitalized children with community acquired pneumonia(CAP)in some areas of Hanzhong. 【Method】 The sputum bacterial culture, identification and drug sensitive test were made for children with CAP by rench Merieux ATB expression identification and susceptibility meter. 【Results】 Of the 323 strains of bacterial pathogens, 11 kinds of bacterial pathogens were isolated.Gram-positive cocci accounted for 38.4%.Of them were streptococcus pneumoniae (SP) (27.9%) and staphylococcus aureus (SA) (10.5%).Gram-negative bacilli accounted for 61.6%, the predominant isolate was Escherichia coli (E.coli) (24.5%), followed by klebsiella pneumoniae (K.pn) (13.9%) and haemophilus influenzae (HI) (8%). SP infection rate was predominant in all age groups of children who were more than 6 months.There was a significant difference in S.pneumonia infection rate between children who were more than 6 moths and less than 6 moths. E.coli infection rate decreased with age.E.coli and K.pn infection rates were significantly different between children who were more than 6 moths and less than 6 moths. The detection rates of K.pneumoniae and E.coli with positive ESBLs were 71.7% and 77.2%,respectively. The resistant rate of HI to ampicillin was 66.7%. While the resistant rate of S.pneumoniae to erythromycin was 98.9%. 【Conclusion】 For a reasonable choice of antibiotic drugs and slowing resistant bacteria producing,it's significant to investegate the bacterial etiology of lower respiratory tract infection , changes in the distribution,and antibiotic resistance in Hanzhong.

Key words: community acquired pneumonia, bacteria, antibiotic resistance, child

摘要： 【目的】 了解2008-2010年于本院住院的儿童社区获得性肺炎(community acquired pneumonia,CAP)病原菌分布及耐药情况。 【方法】 采用法国梅里埃ATB expression鉴定及药敏仪,对儿童CAP患儿进行痰细菌培养、鉴定及药物敏感试验。 【结果】 被检出的323株细菌结果中,G⁺球菌占38.4%,其中主要为肺炎链球菌(streptococcus pneumoniae,SP)(27.9%),金黄色葡萄球菌(staphylococcus aureus,SA)(10.5%);G^-杆菌占61.6%,最常见的是大肠埃希菌(escherichia coli,E.coli)(24.5%),肺炎克雷伯杆菌(klebsiella pneumoniae,K.pn)(13.9%),流感嗜血杆菌(haemophilus influenzae,HI)(8%)。SP感染率>6月患儿与<6月患儿有非常显著差异,且在>6月患儿各年龄组居首位。E.coli和K.pn感染率随着年龄增长下降,<6月与>6月患儿之间有显著差异。产ESBLs株的K.pn和E.coli检出率高达71.1%和77.2%;HI对氨苄西林的耐药率为66.7%;而SP对红霉素的耐药率高达98.9%。 【结论】 本地区下呼吸道感染的细菌病原学的分布及变化,耐药情况,对合理选择抗生素,减缓耐药菌产生具有重要意义。

关键词: 社区获得性肺炎, 病原菌, 耐药性, 儿童