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目的 了解 5岁以下儿童呼吸道感染肺炎链球菌 (SP)、流感嗜血杆菌 (HI)、卡他莫拉菌 (M .Cat)携带株的流行病学特征、耐药情况及其影响因素。方法 对 2 0 0 0年 1月至 2 0 0 3年 5月在北京儿童医院内科门诊就诊的≤ 5岁呼吸道感染儿童进行随机选择问卷调查 ;采鼻咽拭子标本 ;培养、分离、鉴定SP、HI,其中对 2 0 0 2年 1月至 2 0 0 3年 5月的标本同时进行了M .Cat的分离 ;用E test、K B法检测SP、HI对抗生素的敏感性 ,用琼脂扩散法检测M .Cat的药物敏感性 ;评价年龄、居住地、入托、抗生素使用、诊断对病原携带及其耐药株的影响。结果 本文≤ 5岁儿童呼吸道感染SP、HI、M .Cat的携带率分别为 2 8 6%、2 8 3%、1 5 8%。SP青霉素耐药率为 2 3 3% ,HI氨苄青霉素的耐药率为 1 0 2 % ,M .Cat对氨苄青霉素的耐药率高达 90 3%。影响病原携带、抗生素耐药的主要因素有年龄、入托、抗生素使用。结论 ≤ 5岁儿童呼吸道感染携带病原菌株耐药率快速上升 ,抗生素使耐药菌株携带率增高 ,因而合理使用抗生素非常重要。
Objective To understand the epidemiological characteristics and drug resistance of respiratory tract infection of Streptococcus pneumoniae (SP), Haemophilus influenzae (HI) and M. catarrhalis in children under 5 years of age and its influencing factors. Methods A randomized questionnaire survey was conducted on children younger than 5 years of age with respiratory tract infection from January 2005 to May 2003 in Beijing Children’s Hospital. Nasopharyngeal swab specimens were collected for culture, isolation and identification of SP , HI, in which samples from January 2002 to May 2003 were separated at the same time by M.Cat. The sensitivities of SP and HI to antibiotics were detected by E test and KB, Method to detect the drug sensitivity of M.Cat; to evaluate the influence of age, residence, nursery, antibiotic use and diagnosis on pathogen carriers and their resistant strains. Results The carrying rates of SP, HI and M. Cat in children ≤ 5 years of age were 28.6%, 28.3% and 15.8%, respectively. The penicillin-resistant rate of SP was 233%, the resistance rate of HI ampicillin was 102%, and the resistance of M.Cat to ampicillin was as high as 90.3%. Affect the pathogen to carry, the main factors of antibiotic resistance are age, nursery, antibiotic use. Conclusions Respiratory infections in children younger than 5 years old have a rapid increase in the rate of drug-resistant strains carrying the pathogens, and antibiotics increase the carrying rate of drug-resistant strains. Therefore, the rational use of antibiotics is very important.