易感人群下呼吸道医院感染病原菌分布及耐药性监测

Bacteria Caused Lower Respiratory Tract Nosocomial Infection among Suscepted Patients: Their Distribution and Drug Resistance

目的探讨引起易感人群下呼吸道感染的病原菌种类分布,并对其耐药性进行分析,为临床治疗提供用药依据。方法379例下呼吸道感染患者痰及下呼吸道分泌物进行常规细菌培养鉴定,用K-B法测定病原菌耐药性。结果379例病原菌以革兰阴性杆菌为主,共276株占总株数的72.8%;其中铜绿假单胞菌、肺炎克雷伯菌分别占25.9%、15.0%;革兰阳性球菌中耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)分离率分别为58.8%和63.6%;产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌和大肠埃希菌分别占40.4%和37.9%。结论重症监护病房、老年体弱及免疫功能低下患者为易感人群,其病原菌耐药率明显上升,应注重对医院感染病原菌的监测工作。

OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria, which caused lower respiratory tract nosocomial infection among suscepted patients and offer scientific basis for reasonable usage of antibiotics. METHODS The sputa and secretions of lower respiratory tract among 379 cases of lower respiratory tract infection patients were investigated by the routine methods and drug resistance was analyzed by K-B method. RESULTS Most of these bacteria were Gram-negative bacilli（72.8%）, among which Pseudomonas aeruginosa s and Klebsiella pneumoniae were accounted for 25.9% and 15.0%, respectively; meticillin-resistant Staphylococcus aureus （MRSA） and meticillin-resistant coagulase negative S. aureus（MRCNS） were 58.8% and 63.6% of the Gram-positives. Most of extended spectrum β-lactamases（ESBLs） were K. pneumoniae（40.4 %） and Escherichia coli （37.90%）. CONCLUSIONS Most of the lower respiratory tract nosocomial infection patients are aged with low immunity, and increased drug resistance, so we should pay attention to supervising nosocomial infection organisms.