下呼吸道感染细菌谱及耐药性变化趋势分析

Changes of Bacterial Spectrum and Antimicrobial Drug Resistance in Patients with Lower Respiratory Tract Infections.

目的：了解我院近年来下呼吸道感染细菌谱及耐药性变化趋势。方法：对我院2003年-2006年下呼吸道痰标本细菌培养和药敏实验结果进行统计分析。结果：2003-2004年下呼吸道感染病原菌前六位是克雷伯菌30.8％、假单胞菌20．5％、大肠埃希菌12．8％、阴沟肠杆菌10．3％、不动杆菌6．8％和金黄色葡萄球菌6．0％。2005-2006年，位于前六位是假单胞菌30．0％、克雷伯菌18．8％、念珠菌12．5％、不动杆菌11．3％、表皮葡萄球菌10．0％和大肠埃希菌10．0％。产ESBLs菌从9．0％上升至15．6％。大多数病原菌对临床常用抗生素的耐药率增加了10％～20％。结论：在下呼吸道感染细菌中，引起医源性感染的机会性细菌增多，对临床常用抗生素耐药率有明显增加趋势。

Objectives： To realize changes of the bacterial spectrum and drag resistance in the lower respiratory tract infections .Methods： Qualified sputum specimens from 413 patients with lower respiratory tract infections from 2003 to 2006 were cultured for bacterial isolation. The bacteria were identified by Merieux TPI. The antibiotic sensitivity tests were determined by Merieux ATPI. ESBLs were determined by K-B methods. Results： From 2003 to 2004, the 6 most common isolated bacteria were Klebsiella, Pseudomonas, Escherichia coli, Enterobacter cloacae, Acinetinbacter and Staphylococcus aureas, with isolating rates of 30.8 %, 20.5 %, 12.8%, 10.3%, 6.8% and 6.0%, respectively. From 2005 to 2006, the 6 most common isolated bacteria were Pseudomonas, Klebsiella, Candida albicans, Acinetinbacter, Staphylococcns epidennidis and Escherichia coli, with isolating rates of 30.0%, 18.8%, 12.5%, 11.3%, 10.0% and 10.0%, respectively.The prevalence of bacteria producing ESBLs rose from 9.0% to 15.6% .The bacterial resistance rates to the most of antimicrobial drugs used routinely were higher by 10% to 20% from 2005 to 2006 than from 2003 to 2004. Conclusions： Opportunistic pathogens caused hospital acquired infection rise in the lower respiratory tract infections. The bacterial resistance rates to antimicrobial drugs used routinely increase.