呼吸道感染病原菌的变迁及耐药性分析

A study of pathogen variance and drug resistance of respiratory tract infection

目的分析本院呼吸道感染病原菌的变迁及耐药趋势,为临床治疗和控制医院感染提供帮助。方法统计分析本院2004~2006年呼吸道感染病原菌结构及耐药情况。结果在4551例呼吸道标本中分离出病原菌2362株,占51.9%,其中以革兰阴性杆菌为主,占73.1%,铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌和阴沟肠杆菌分列前5位;革兰阳性球菌占12.0%,金黄色葡萄球菌、表皮葡萄球菌分列前2位;真菌占14.9%,以白假丝酵母为主;药敏结果提示碳青霉烯类抗生素对革兰阴性杆菌作用最强,革兰阳性球菌对万古霉素高度敏感,对其他抗菌药物存在不同程度的耐药。结论革兰阴性杆菌是呼吸道感染的主要致病菌,但细菌种类及耐药性在不断发生变化,应根据药敏结果选择抗菌药物,以抑制细菌耐药性的发展并提高感染性疾病的治疗效果。

Objective To analyze pathogen variance of respiratory tract infection and drug resistance, and to offer an aid to clinical therapy and control of hospital-acquired infection. Methods A statistical analysis was performed about respiratory tract infection associated pathogen structure and drug resistance from 2004 to 2006. Results Totally 2 362 strains of pathogenic bacterium were isolated from 4 551 cases of respiratory tract specimens, and the isolated rate was 51.9%. Among them, gram-negative bacilli occupied 73.1%, gram positive coccus 12%, and fungi 14.9%. The 5 common gram-negative bacilli were Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumomae, Aemetobacter baumannii and Enterobaeter. Staphylococcus aureus, S. epidermidis were the 2 main pathogens in gram-positive coccus and Candida albicans was the most common in fungi. Gram-negative bacteria were the most sensitive to imipenem. And gram-positive bacteria were the most sensitive to vancomycin. Conclusion Gram-negative bacilli are the dominant pathogens in respiratory tract infection. But there are always some changes in categories and drug resistance. We ought to select antibacterial drug basing on drug sensitivity test, so as to restrain the development of bacterial drug resistance and improve the effect of therapy.