162例下呼吸道医院感染的病原菌分布及药敏分析

Distribution of pathogens and susceptibility test in 162 patients with nosocomial lower respiratory tract infections

目的:研究本院下呼吸道医院感染病原菌种类及药敏情况。方法:采集晨起合格痰或经气管插管采集的下呼吸道分泌物,用血平皿和巧克力平皿接种培养分离出的病原菌,用法国生物梅里埃API鉴定系统鉴定,药敏试验采用K-B法。结果:共分离出病原菌162株,其中以革兰阴性杆菌为主,共139株,占85.8%;革兰阳性球菌共23株,占14.2%。革兰阴性杆菌对碳青霉烯类抗生素和β内酰胺类抗生素/酶抑制剂复合制剂(头孢哌酮/舒巴坦)的敏感度较高。革兰阳性球菌主要是金黄色葡萄球菌,耐甲氧西林的金黄色葡萄球菌(MRSA)占73.7%,其对青霉素、苯唑西林、环丙沙星、红霉素、克林霉素有很高的耐药率(78.6%～100.0%),最为敏感的是去甲万古霉素。结论:本院发生的下呼吸道医院感染中,以革兰阴性杆菌为主,对常见抗生素耐药性较高。

Objective To study the distribution of pathogens and drug susceptibility test in patients with nosocomal lower respiratory tract infections. Methods The phlegm and lower respiratory tract secretion were collected by trachea cannula. Pathogens were then cultivated and segregated. The susceptibility test was done by K-B methods. Results A total of 162 isolates of pathogens were gained, including 139 gram-negative bacilli （85.8%） and 23 gram-positive cocci（14.2%）. Gram-negatlve bacilli were sensitive to carbapenem and beta-laetam/lactamase inhibitor. In the gram-positive cocci, the most commonly seen pathogen was Staphylococcus aureus, among which methieillin-resistant Staphylococcus aureus （MRSA） accounted for 73.7%. The resistant rates to penicillin, oxacillin, ciprofloxacin, and Clindamycin erythromycin were quite high （78.6%-100.0%）. The most sensitive drug was norvancomycin. Conclusions Gram-negative bacilli, that have high resistant rates to the commonly used antibiotics, are the most frequently found in the patients with nosocomial lower respiratory tract infections.