Pathogen Distribution And Bactrial Resistance In Children With Severe Community-acquired Pneumonia

Objective:To investigate the distribution of pathogens and bacterial resistance in children with severe community-acquired pneumonia(CAP).Methods : A total of 522 children with severe CAP who were hospitalized in 2016 were enrolled as study subjects.Sputum specimens were collected for bacterial identification and drug sensitivity test and detection of seven common respiratory viruses,Mycoplasma pneumoniae(MP)-PCR and Chlamydia trachomatis(CT)-PCR.And the distribution of pathogens and bacterial res istance were analyzed.Results:Of all the 522 children with severe CAP,419(80.3%)were found to have pathogens,among whom 190(45.3%)had mixed infection.A total of 681 strains of pathogens were identified,inc luding 371 bacterial strains(54.5%),259 viral strains(38.0%),12 fungal strains(1.8%),15 MP strains(2.2%),and 24 CT strains(3.5%).The top five pathogenic bacteria were Haemophilus influenzae,Streptococcus pneumoniae,Staphylococcus aureus,Escherichia coli and Klebsiella pneumonia.And the top detected virus was RSV.There were significant differences in the distribution of bacterial,viral,MP,and fungal infections between different age groups(P<0.05).Bacterial,fungal,viral infections mainly occurred in infants,MP infections occurred mainly in preschool children.There were significant differences in the incidence rate of viral infection between different season groups(P<0.05),with the highest inc idence rate in winter.The drug-resistance rates of Streptococcus pneumoniae to erythromycin,tetracyc line,c lindamycin reached above 85%,and the drug-resistance rates of Staphylococcus aureus to penicillin reached 85.1%,and to erythromyc in,clindamycin were above 50%;But they were all sensitive to vancomycin and linezolid.The drug-res istance rates of Haemophilus influenzae to ampicillin was 100%,and to compound sulfamethoxazole,cefaclor and cefuroxime were above 60%,but it was sensitive to cefotaxime.The drug-res istance rates of Escherichia coli and Klebsiella pneumoniae to ampicillin,cefotaxime,ceftriaxone were above 60%,but they were sensitive to carbapenems and compound preparation of enzyme inhibitors.Conclusions:Bacteria are the main pathogens in children with severe CAP and mixed infection is prevalent.Bacterial,fungal,viral infections mainly occur in infants,MP infections occur mainly in preschool children.The top five pathogenic bacteria were Haemophilus influenzae,Streptococcus pneumoniae,Staphylococcus aureus,Escherichia coli and Klebsiella pneumonia.And the drug-resistance rates of these pathogenic bacteria are high.