下呼吸道感染患者痰培养和药敏结果分析

A study on bacterial spectrum and drug resistance in patients with lower respiratory tract infection

目的调查近年来本院呼吸内科病房下呼吸道感染患者病原菌分布特点及对常用抗菌药物的敏感性和耐药性。方法下呼吸道感染患者1465痰标本行细菌培养,采用纸片扩散法(Kirby-Bauer法),按NCCLS标准判定敏感菌珠。结果分离出细菌410株,革兰阴性杆菌占68.05%;其中,排前几位的依次为铜绿假单胞菌、肺炎克雷白杆菌、鲍曼不动杆菌、大肠杆菌、阴沟肠杆菌;革兰阳性球菌占31.95%,其中以表皮葡萄球菌、金黄色葡萄球菌、肺炎链球菌为优势菌。革兰阴性杆菌对亚胺培南、头孢吡肟、丁胺卡那霉素、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦表现出较好的敏感性;革兰阳性球菌对万古霉素、哌拉西林/他唑巴坦、利福平、新诺明有较好的敏感性。结论住院患者下呼吸道感染以革兰阴性杆菌为主且多重耐药;临床上及时掌握病原菌及其耐药性的最新动态,合理使用抗生素及细菌耐药性的监测尤为重要。

Objective To study the bacterial characteristics, drug sensitivity and resistance of strains isolated irom patients with lower respiratory tract infection. Methods From 2004 to 2006,410 clinical isolates were acquired from phlegm specimens,and bacterial susceptibility test was carried out by Kirby-Bauer method according to NCCLS standards. Results Gram-negative rod was at 68.05% .Pseudomonas aerations,Klebsiella,Escherichia coli,Baumanii, Haemophilus influenzae,and Enterbacter cloacae were in the first place. Gram-positive cocci was at 31.95%. Pathogenic streptococci, Staphylococcus aureus,Streptococcus pneumoniae were in the first place. The most active agents against Gram negative organisms were tienam,cefepime,kanamycin and pipeacilline/tazobactam. Gram-positive coccis were sensitive to vancomycin,piperacillin,piperacillin/tazobactam. Conclusion Pathogens of patients with lower respiratory tract infection are mainly Gram negative organisms and they are multidrug-resistance;it is essential to pay more attention to the continuous surveillance of antimicrobial resistance in clinics and prevent transmission and epidemic of these resistance strains.It is very important to select antibiotics for the treatment of infection rationally.