超声雾化诱导痰的病原菌特点及其耐药性分析

The study of pathogen and antibiotics about ultrasonic induced sputum

目的探讨超声雾化诱导痰的病原菌特点及耐药性,为临床合理使用抗生素提供必要的依据。方法对呼吸内科送检的超声雾化诱导痰标本,按《全国临床检验操作规程》有关下呼吸道标本的处理方法进行病原菌的分离鉴定和药敏试验,将其结果进行回顾性分析。结果超声雾化诱导痰培养阳性率为70.6%(338/478)。检出病原菌以阴性菌为主,占64.8%(219/338),以铜绿假单胞菌(22.4%)、肺炎克雷伯菌(12.4%)为优势菌;阳性菌占18.04%(61/338),以肺炎链球菌(5.91%)及A群链球菌(5.62%)为优势菌;真菌占13.9%(47/338),以白色念珠菌为主(11.5%)。药敏结果提示大多数病原菌对青霉素类的耐药率高于80%,三代头孢菌素耐药率达50%以上,环丙沙星敏感率下降到45.9%,耐药率低于25%以下的仅有泰能、四代头孢、啊米卡星、万古霉素及含β-内酰胺抑制的复合药。结论诱导痰病原菌的分离率高,有效地协助临床合理使用抗生素,减少耐药菌株的产生。第三代头孢菌素诱导超广谱β-内酰胺酶(ESBLs)的产生更应受到临床的重视。

Objective To investigate bacteriological feature and drug-resisitance of bacteria in ultrasonic induced sputum . Methods The results of sputum specimens cultivated and tested by drug sensitivity were retrospectively analyzed. Results The positive ratio of ultrasonic induced sputum cultivation test is70.6% （338/478）. The dominating bacterium in the study is gram-negative bacteria （64.8%）;the followed are gram-positive bacteria（18.01%） and fungi（13.9%）. The predominant Gbacterium including Pseudomonas aeruginosa（ 22.4% ） Klebsiella （12.4% ） ;The gyam-positive bacteria is 18.04%（61/338）, including A-Streptococcus （5.62%）. Streptococcus pneumoniae （5.91%） and Candida albicans （11.5%）. The drug sensitive test showed that the majority of bacteria are drug resistance to penicillin, the third generation of cephalospotin and ciprofloxacin, the sensitivity ratio is only from 13.2% to 45.9% . Conclusion The positive ratio of ultrasonic induced sputum cultivation test is worthy of adoption in clinic.