成都地区老年人下呼吸道常见革兰阴性杆菌感染耐药分析

Common Gram-negative Bacilli Infection and Antibiotic Resistance Analysis in Lower Respiratory Tract Disease among Aged People in Chengdu Region

目的监测成都地区老年下呼吸道感染患者分离的常见5种革兰阴性杆菌的耐药状况。方法采取2002年1月-2004年6月符合老年革兰阴性杆菌下呼吸道感染诊断患者的痰标本，采用全自动VITEK32仪对532株G^-杆菌进行分析。结果成都地区老年人下呼吸道感染最常见的5种革兰阴性杆菌为大肠埃希菌（27．44％）、肺炎克雷伯菌（20．49％）、铜绿假单胞菌（18．23％）、鲍氏不动杆菌（17．67％）、阴沟肠杆菌（16．17％），对阿奠西林／克拉维酸、氨苄西林、头孢唑林、复方新诺明的耐药率〉40％，大肠埃希菌、肺炎克雷伯菌产超广谱β-内酰胺酶的分离率为20．78％。结论常规对细菌和产ESBLs细菌的监测，可提供早期治疗并控制老年人下呼吸道感染的依据。

OBJECTIVE TO monitor drug resistance of the 5 kinds of Gram negative bacilli isolated from the old patients with lower respiratory tracts infection in Chengdu region. METHODS From Jan 2002 to Jun 2004, we collected the sputum samples of the old patients who were diagnosed lower respiratory tract infection with Gram negative bacilli, which were analyzed with automatic VITEK32 and 532 strains of common Gram negative bacilli were identified. RESULTS The most common 5 kinds of Gram negative bacilli, which were cultured among old patients in Chengdu region with lower respiratory tracts infection, were： Escherichia coli （27.44%）,Klebsiella pneumoniae （ 20. 49%）, Pseudomonas aeruginosa （ 18.23%）, Acinetobacter baumannii （17.67%）, and Enterobacter cloacae （16.17%）. For above bacteria, the ratio of the resistance to amoxicillin/clavulanic acid, ampicillin, cefazolin, compound sulfamethoxazole was over 40%. And the isolating rate of ESBLs produced by E. coli and K. pneumoniae was 20. 78%. CONCLUSIONS Monitoring the common bacteria and ESBLs-producing bacteria precisely can provide therapy, guide to early cure and control lower respiratory tracts infection of aged patients effectively.