Pathogens And Antibiotic Resistance Of Community-acquired Pneumonia In Children Under 5 Years Old In Lanzhou

Objective The purpose of this study is to investigate the pathogens and antibiotic resistance of community-acquired pneumonia(CAP) in children under 5 years old in Lanzhou, analyse factors that may influence the distribution of common pathogens and guide the empirical therapy of CAP.Methods Selected 610 CAP cases of hospitalized children in the Children Hospital of Gansu province (Department of pediatrics of Lanzhou University the Second Hospital) from August 2008 to 2010, actualized sputum culture, then test of drug sensitivity by the MicroScan auto SCAN-4 which America DADE company produced, and statistical analysis. The results were evaluated according to standards of the Clinical and Laboratory Standards Institute (USA).Results In the 610 cases,211 specific pathogens were identified in 197 cases, accounting for 32.3%. It included 84 ones of gram-positive (G+) bacteria (60.2%) and 127 ones of gram-negative (G-) bacteria (39.8%). Among the isolated gram-positive bacteria, Staphylococcus aureus was the most (accounting for 45.2%), and the next was Streptococcus pneumoniae (23.8%). The isolated gram-negative bacteria were mainly Escherichia coli (37.0%), Klebsiella pneumoniae (16.5%), Enterobacter cloacae (15.7%) and Pseudomonas aeruginosa (7.9%). Drug resistance of the G+cocci to Penicillin, Penbritin and Erythromycin was particularly common, while Vancomycin, Quinupristin and Linezolid showed nearly 100%sensitivity. For the main G" bacilli, Ampicillin, Piperacillin, second and third generation cephalosporin had high drug resistance rate, but Imipenem and Amikacin presented high sensitivity. Besides,10 cases put fungal infection together, which were almost sensitive to commonly used antifungal agents. The isolating rates of G+and G" bacteria had no significant differences in the CAP cases from urban and rural. In December, January, February, March, April and July the detected bacteria counted more than any other month. So the main pathogenic bacteria of CAP were more popular in spring and winter. But,in each season, the constituent ratios of G+and G" bacteria had no obvious differences.Conclusion The dominant pathogen during the recent two years in this region for the hospitalized children with CAP was G" bacilli, and it showed the high drug resistance rate. The isolating rates of G+and G" bacteria had no significant differences in the CAP cases from urban and rural. The main pathogenic bacteria of CAP were more popular in spring and winter. But in each season, the constituent ratios of G+and G" bacteria had no obvious differences.