危重患者肺部感染病原菌分布及耐药性分析

Drug Resistance and Pathogens in Critically Ill Patients with Pulmonary Infection

目的了解危重病患者肺部感染的病原菌分布及其耐药性。方法对103例危重病肺部感染患者,171次阳性痰培养结果及药物敏感试验进行分析。结果G+球菌29株,占17.0%,其中金黄色葡萄球菌15株、表皮葡萄球菌11株,肠球菌属3株;G-杆菌107株,占62.6%,主要为嗜麦芽寡养单胞菌、铜绿假单胞菌、鲍氏不动杆菌、洋葱伯克霍尔德菌及肺炎克雷伯菌等;真菌35株,占20.5%,主要为白色念珠菌及热带念珠菌;药物敏感试验显示不同病原菌对抗菌药物多重耐药率均较高,但不同抗菌药物耐药率差异较大。结论铜绿假单胞菌、肺炎克雷伯菌等其他G-杆菌均存在多重耐药;进行病原学监测,了解流行菌株分布和耐药趋势,减少抗菌药物滥用,对于降低医院肺部感染发生率以及降低致病菌的耐药率有着重要的意义。

OBJECTIVE To investigate the pathogens distribution and their antibiotic resistance in critically ill patients with pulmonary infection. METHODS Totally 171 isolates from sputa were studied and the drug sensitive test was analyzed in 103 critically ill patients. RESULTS These results showed that：29 G^＋ bacteria strains occupied 17.0%, there were 15 Staphylococcus aureus strains, 11 S. epidermidis strains and 3 Enterococcus strains, respectively. In 107 G^- bacteria strains occupied 62. 6% were composed Stenotrophomonas maltophilia, Acinetobacter baumannii, Burkholderia cepacia and Klebsiella pneumoniae, and 35 strains were fungi, accounted for 20.5%, the main fungi were Candida albicans and C. tropicalis. The result of drug sensitive test showed that there were high rates of multiple drug resistance in most bacteria strains, but there were different drug resistance rates to different antibiotics. CONCLUSIONS G^- bacilli play an important role in the pulmonary infections of these critically ill patients, the opportunistic pathogens, such as S. maltophilia are the main G^- pathogens, and there are high percentages of drug resistance. The other bacteria such as S. aureus, K. pneumoniae, etc, have a multidrug resistance. Inspecting pathogens and studying the trend of their drug resistance are very important in reducing drug abuse and decreasing the rate of infection in hospital.