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目的 分析气管支气管异物患儿气道内分泌物的病原菌分布及药敏结果,为临床用药提供依据.方法 收集1 125例气管支气管异物取出术时异物所在气管支气管分泌物,行细菌培养及药敏实验,收集阳性结果并进行分析.结果 1 125例标本有218例检出病原菌,阳性率19.38％.革兰阴性菌126株(57.79％),其中流感嗜血杆菌76株(34.86％),大肠埃希菌10株(4.59％),阴沟肠杆菌及铜绿假单胞杆菌各7株(3.21％),肺炎克雷杆菌6株(2.75％).检出主要革兰阴性杆菌对头孢吡肟、头孢他啶、亚胺培南及阿米卡星的敏感度较高,无耐美罗培南及环丙沙星株.革兰阳性菌92株(42.21％),主要为肺炎链球菌80株(36.69％)及金黄色葡萄球菌9株(4.13％),检出的革兰阳性杆菌未发现对头孢吡肟、万古霉素、左旋氧氟沙星及替考拉宁耐药株.结论 在病原菌分布中,革兰阴性杆菌以流感嗜血杆菌为主,革兰阳性杆菌则以肺炎链球菌为主.流感嗜血杆菌对第三代头孢、亚胺培南及美罗培南有较高敏感性,肺炎链球菌对头孢吡肟、万古霉素、左旋氧氟沙星及替考拉宁有较高敏感性.

Objective To analyze the distribution and drug susceptibility of the pathogenic bacteria in the airway secretions in children with tracheobronchial foreign bodies so as to assist physicians in clinical prescription.Methods Sputum specimens of 1 125 children with tracheobronchial foreign bodies were collected in removal of the foreign bodies by rigid bronchoscope,and the drug susceptibility test was performed.Results Pathogenic bacteria were detected in 218 (19.4％) of 1 125 sputum specimens.Among the pathogenic bacteria,126 (57.79％) strains were gram-negative bacilli,consisting of 76 (34.86％) strains of Haemophilus influenzae,10 (4.59％) strains of Escherichia coli,7 (3.21％) strains of Sewer enterobacter,7 (3.21％) strains of Pseudomonas aeruginosa,and 6 (2.75％) strains of Klebsiella bacillus; and 92 (42.21％) strains were gram-positive bacilli,consisting of 80 (36.69％) strains of Streptococcus pneumonia and 10(4.59％)strains of Escherichia coli.Most of detected gram-negative bacilli were highly sensitive to cefepime,ceftazidine,imipenem and amikacin,no strains were resistant to meropenem and ciprofloxacin.None of the detected gram-positive bacilli were resistant to cefepime,vancomycin,levofloxacin and teicoplanin.Conclusions The Haemophilus influenzae of gram-negative bacilli and the Streptococcus pneumonia of gram-positive bacilli are the main pathogenic bacteria existing in the airway secretions of children with tracheobronchial foreign bodies.The Haemophilus influenzae were highly sensitive to cephalosporin,imipenem and amikacin,and the Streptococcus pneumonia to cefepime,vancomycin,levofloxacin and teicoplanin.