Distribution of sputum pathogens and characteristics of bacterial resistance in 450 children with severe community-acquired pneumonia

ObjectiveTo investigate the distribution of pathogens and bacterial resistance in children with severe community-acquired pneumonia(CAP).

MethodsOne thousand and fourteen children with SCAP from 2017 to 2018 were investigated, and 450 cases were selected after exclusion.One hundred and twenty children aged 1 to < 3 years, 151 children aged 3 to >6 years and 179 children aged ≥ 6 years were divided into the infant group, preschool group and school-age group, respectively.A disposable sputum suction tube was used to absorb sputum in oral cavity, and the sputum of children with mechanical ventilation was sucked through organ insertion catheter device.The positive nucleic acid was set as the virus standard, the molecular biology method was used to detect.The fluorescent quantitative PCR was used to detect Mycoplasma pneumoniae(MP) in sputum samples.The patients were treated with intravenous injection of cefuroxime sodium, oral azithromycin dry suspension and mechanical ventilation.

ResultsAmong 450 cases, the positive pathogens in sputum of 389 cases were identified, and the positive rate of which was 86.44%.A total of 632 pathogens were detected, and the proportion of bacteria and viruses were 56.01% and 35.60%, respectively.The differences of the distribution rates of viruses, bacteria, MP, Chlamydia trachomatis(CT) and fungi infection among the infant group, preschool group and school-age group were statistically significant(P < 0.01).The distribution differences of the virus, bacteria, MP, CT and fungus infection among four seasons were statistically significant(P < 0.01), and the difference of the mixed infection was not statistically significant(P>0.05).Haemophilus influenzae was low resistant to ofloxacin, and Escherichia coli was resistant to imipenem and cefaclor.Streptococcus pneumoniae was not resistant to vancomycin, linezolid and penicillin, and low resistance to amoxicillin.Staphylococcus aureus was not resistant to vancomycin and linezolid.

ConclusionsBacteria are the main pathogens in CAP.The detection rates of children's virus, bacteria, MP and CT are high, and the bacterial resistance is severe.The targeted antibiotics is recommended to use after the pathogen and bacterial resistance tests are identified.