Pathogens And Drug Sensitivity Analysis Of Children With Acute Respiratory Tract Infection In Hengyang Area

Objective: This study intends to analyze the distributions and drug sensitivities of sputum culture pathogens in 0-14 years old children with acute lower respiratory tract infection in hengyang,hunan province during 2016-2018,so as to provide reference for the epidemiology and clinical medications of acute lower respiratory tract infection in children in hengyang.Methods: 8835 cases of sputum samples were collected from of 0 to 14 years old children diagnosed with acute lower respiratory tract infection in 2016-2018,and samples were come from five first-class hospitals in hengyang,hunan province including the first affiliated hospital of university of South China,affiliated Nanhua hospital of university of South China,the central hospital of hengyang,Hengyang No.1 people's hospital and hengyang maternal and child health care hospital.Samples were prepared for sputum smears with Gram staining and examination with light microscope,and cultured simultaneously in Columbia blood agar plate,chocolate agar plate and macconkey agar plate.Then a fully automatic microbe analysis system was used to identify the isolated suspicious pathogenic bacteria.The susceptibilities of identified pathogens to antimicrobial agents were detected by automated instrument method and disk diffusion method(k-b method).Results: 4276 of 8835 cases were isolated from sputum specimens,and the detection rate was 48.4%.Gram-positive bacteria accounted for 50.0%,among which Streptococcus pneumoniae(31.8%)and Staphylococcus aureus(11.9%)were the most detected.Gram-negative bacteria accounted for 46.29%,mainly Klebsiella pneumoniae(12.7%),Escherichia coli(12.6%)and Acinetobacter(6.5%).Fungi accounted for 3.7%,mainly Candida albicans(3.6%).The positive rate of gram-negative bacteria were slightly higher than gram-positive bacteria in sputum of children aged less than 1 year.Gram-positive bacteria were the main pathogenic bacteria in children aged between 1 and 4 years.Gram-negative bacteria were the main pathogenic bacteria in 4-14 years old children.S.pneumoniae accounted for the largest proportion of pathogenic bacteria among children ages 0 to 8,while K.pneumoniae accounted for the largest proportion of pathogenic bacteria among children ages 8 to 14.The detection rate of pathogenic bacteria in male children was slightly lower than that in female children.The detected pathogens had different degrees of resistance to different antimicrobial agents,but no vancomycin and linezolid resistant strains were found in gram-positive bacteria.Drug resistance rates of S.pneumoniae to tetracycline and erythromycin were 89.7% and 93.2%,while drug resistance rate to penicillin G was only 2.2%,and S.pneumoniae isolations are sentivities to quinolones.Drug resistance rates of Streptococcus viridans to tetracycline and erythromycin were lower than those of S.pneumoniae,but S.viridans isolations are relativly sentive to other antibiotics.Drug resistance rates of S.aureus to penicillin G and benzocillin were 96.6% and 38.7% respectively,and the drug resistance rates to clindamycin and erythromycin were more than 40%.Drug resistance rates to antibiotics of coagulase negative staphylococcus was significantly higher than those of S.aureus.From 2016 to 2018,drug resistance rates of gram-negative bacteria generally showed a downward trend,and they were generally sensitive to quinolones and aminoglycosides,and relatively resistant to ?-lactam antibiotics and sulfamethoxazole.Drug resistance rates of enterobacter and Acinetobacter baumannii were significantly lower than those of K.pneumoniae,Pseudomonas aeruginosa and haemophilus,and the drug resistance rates of E.coli against ceftriaxone and ampicillin were 57.8% and 89.8%,respectively.Drug resistance rates of haemophilus to amoxicillin/clavulanic acid,ampicillin/sulbactam and ampicillin were more than 50%,and resistance rate to sulfamethoxazole was high to 80%.Drug resistance rates of Moraxella catarrhalis to tetracycline,compound neostigmine and amoxicillin/clavuric acid were lower than 30%.Conclusions: The main pathogens of children's acute lower respiratory tract infection in hengyang area from 2016 to 2018 are S.pneumoniae,K.pneumoniae,E.coli,S.aureus and acinetobacter;The isolated pathogenic bacteria have different levels of drug resistance.