呼吸内科下呼吸道感染的细菌分布及药物敏感分析

Bacterial Distribution and Drug-Sensitivity in Lower Respiratory Tract Infection in Department of Respiratory Medicine

目的分析二甲医院呼吸内科普通病房呼吸道感染患者的痰细菌培养中细菌分布、主要细菌对药物敏感性,以协助临床合理选择抗生素,降低医院感染发生率.方法以回顾性方法,对2004～2005年我院呼吸内科病房下呼吸道感染所有患者进行分析,并与全院患者进行对比.结果呼吸内科2005年医院感染发生率为10.18%,高于全院的3.09%;呼吸道感染以革兰阴性杆菌为主,革兰阳性菌以葡萄球菌为主,值得注意的是在2004年真菌感染的比例较高;主要革兰阴性杆菌为铜绿假单胞菌,2004年最敏感的药物为哌拉西林/他唑巴坦,2005年为氨基糖苷类抗生素;革兰阳性菌对万古霉素敏感.结论呼吸内科以下呼吸道感染为主,医院感染率高,以革兰阴性杆菌为主,真菌占一定的比例,要选用敏感抗生素,提高机体抵抗力,减少住院时间,降低医院感染率.

OBJECTIVE To analyze the bacterial distribution and drug-sensitivity in sputum bacterial culture of the hospitalized patients with respiratory tract infection in the department of respiratory medicine to help reasonably choose the antibiotics and reduce the nosocomial infection rate. METHODS The bacterial infection of all the hospitalized patients with lower respiratory tract infection in the department of respiratory medicine from 2004 to 2005 was analyzed retrospectively and compared with all the patients of the hospital. RESULTS The nosoeomial infection rate of the department of respiratory medicine in 2005 was 10. 18%, which was higher than the rate of nosocomial infection of the whole hospital（3.09%）. The Gram-negative bacteria were the main ones infected through respiratory tract. What should be paid attention to was the comparably higher fungal infection rate in 2005. The main Gram-negative bacteria were dominated by Pseudomonas aeruginosa. The most sensitive drug was piperacillin＋ tazobactam in 2004 and aminoglycoside antibiotics in 2005. The Gram-positive bacteria were most sensitive to vancomycin. CONCLUSIONS The nosocomial infection is dominated by lower respiratory tract infection in the department of respiratory medicine. The nosocomial infection rate, dominated by Gram-negative bacteria is high. In order to decrease nosocomial infection rate, cross infection should be avoided, sensitive antibiotics be chosen, body resistance be enhanced and hospital stay be reduced.