Clinic study on distribution and transition and drug resistance of bacteria in children with lower respiratory tract infection

Abstract

Objective To investigate the distribution,transition and changes of drug resistance of bacteria in children with acute lower respiratory tract infection (ALRI) of Kunming by conducting a consecutive clinical study of 9 years.Methods Sputum specimens for bacterial cultures were collected from children with ALRI who had been admitted to ICU and general wards of Kunming Children's Hospital from Jan 2002 to Dec 2010.Antibiotic susceptibility tests were performed after bacteria had been identified.Results Pathogenic bacteria distribution:(1) total positive rate of pathogenic bacteria was 18.52％ (3006/16 229) ;gramnegative bacteria accounted for 75.35％ ; gram-positive bacilli accounted for 20.23％ ; fungi accounted for 4.42％ ;Escherichia coli was the most common pathogenic bacteria in children with ALRI,followed by Klebsiella pneumonia,Streptococcus pneumoniae,Hemophilus,Enterobacter cloacae,Pseudomonas aeruginosa.(2) Gram-negative bacteria such as Escherichia coli and Klebsiella pneumonia were the two most common bacteria in ICU,Staphylococcus aureus was the most common gram-positive bacteria in ICU;while Hemophilus took the palace of Klebsiella pneumonia as the second most common gram-negative bacteria in general wards;Streptococcus pneumoniae was the most common gram-positive bacteria in general wards.Drug resistance:compared with the years of 2002 ～ 2006,the rate of drug resistance between 2007 and 2010 had increased,and multiple drug resistance status was present.Resistant strains to imipenem and vancomycin were not found.Constituent ratio and proportion of Escherichia coli and Klebsiella pneumoniae producing extended spectrum β-lactamases showed the trend of increase by years.Conclusion Gram-negative bacilli were the main bacteria pathogens in children with ALRI in Kunming between 2002 and 2010,among which escherichia coli was the most common pathogen.Bacteria distribution and transition were different in different wards.The drug resistance of bacteria showed the trend of increase in the recent years. Key words: Acute low respiratory infection; Pathogenic bacteria; Antibiotics; Drug resistance