痰标本常见病原谱变化趋势及耐药性分析

Analysis of Bacterial Spectrum and Drug Resistance in Sputam Specimen

目的研究我院近年来下呼吸道常见病原谱变化趋势及耐药性,提高对下呼吸道感染性疾病的认识和合理使用抗生素。方法对我院2003～2006年下呼吸道标本细菌培养和药敏实验结果的调查统计分析。结果1组下呼吸道病原菌前五位分别是:克雷伯氏菌属30.5%,假单胞菌属18.6%,大肠埃希氏菌12.7%,阴沟肠杆菌10%和不动杆菌6.7%;2组下呼吸道病原菌前五位是:假单胞菌属30.0%,克雷伯氏菌属14.0%,念珠菌12.5%,不动杆菌属11.2%和表皮葡萄球菌10.0%。产超广谱β内酰胺酶从8.9%增至15.6%,大多数病原菌耐药率都有增加的趋势,仅万古霉素和美罗培南、亚胺培南分别对革兰氏阳性菌和革兰氏阴性菌表现优秀。结论下呼吸道机会致病菌感染增多,且对多数抗生素耐药率有明显增加趋势。

Objective To realize changes of the bacterial spectrum and drug 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. ES-BLs were determined by K-B methods. Results From 2003 to 2004,the 6 most common isolated bacteria were Klebsiella,Pseu-domonas,Escherichia coli,Enterobacter cloacae, Acinetinbacter and Staphylococcus aureas, with isolating raes of 30.8%, 20.5%, 12.8%, 10.3%, 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. Conclusion Opportunistic pathogens caused hospital acquired infection rise in the lower respiratory tract infections. The bacterial resistance rates to antimicrobial drugs used routinely increase.