Value of bacteria culture and antimicrobial susceptibility test of bronchoalveolar lavage fluid in diagnosis and treatment of refractory pneumonia in children
10.3760/cma.j.issn.2095-428X.2013.04.007
- VernacularTitle:支气管肺泡灌洗液细菌培养及药敏试验在儿童难治性肺炎诊治中的价值
- Author:
Li-Xin REN
1
;
Wei GUO
;
Han-Quan DONG
;
Zhuo FU
;
Jing NING
;
Yu-Jing XIA
;
Li-Ya WAN
Author Information
1. 300074,天津市儿童医院呼吸科
- Keywords:
Bacteria;
Antimicrobial susceptibility test;
Bronchoalveolar lavage fluid;
Refractory pneumonia;
Child
- From:
Chinese Journal of Applied Clinical Pediatrics
2013;28(4):258-260
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the value of bacteria culture and antimicrobial susceptibility test of bronchoalveolar lavage fluid(BALF) in diagnosis and treatment of refractory pneumonia in children.Methods Three hundred and sixty-eight patients who failed to a 2 weeks,routine antibiotic therapy,hospitalized in Department of Respiration,Tianjin Children's Hospital from Aug.2010 to Dec.2011,were diagnosed as refractory pneumonia.They were examined with fiberoptic bronchoscopy,BALF was collected,and bacteria culture and antimicrobial susceptibility test in BALF were performed.Results One hundred and ninety-five stains of bacteria were identified from BALF of 181 cases.There were 10 (5.1％) gram-positive stains (7 Streptococcus pneumonia and 3 Staphylococcus aureus),48 stains (24.6％) were gram-negative bacterial,and the predominant were Pseudomonas aeruginosa (23 stains,11.8 ％),followed by Serratia marcescens and Stenotrophomonas maltophilia (6 stains respectively,3.1％).There were 1 Staphylococcus aureus with positive beta-lactamases and 1 Pseudomonas fluorescens with positive AmpC enzyme.There were 1 fungi (0.5％)and 136 parasitic bacteria stains(69.7％).Gram-positive stains were universally resistant to Erythromycin,Penicillin,Cefuroxime,and susceptible to Chloramphenicol,Levofloxacin,Vancomycin.Gram-negative stains were universally resistant to Ampicillin,Cefazolin,Cefuroxime,Cefotaxime,and susceptible to Amikacin,Cefepime,Cefoperazone sulbactam,Meropenem,Imipenem,Levofloxacin,Ceftazidime,Piperacillin.There were mixed infection in most children and the predominant pathogen was Mycoplasma pneumoniae.Conclusions Bacteria culture of BALF is relatively reliable and instructively recommended for the treatment of refractory pneumonia in children,meanwhile,it can help choose the antibiotics reasonably.
