肺疾病患者下呼吸道感染病原菌分布及耐药性分析

Analysis of pathogen distribution and drug resistance on patients with lower respiratory tract infection

目的:了解肺疾病患者下呼吸道感染病原菌分布及耐药情况,指导临床抗感染的经验性治疗。方法:采用回顾性统计分析方法,对2007年1月～2008年12月,我医院呼吸内科住院的肺疾病患者下呼吸道分泌物中的致病菌及药敏进行统计分析。结果:共分离出致病菌567株,其中,革兰阴性杆菌357株(63.0%),真菌186株(32.8%),革兰阴性球菌24株(4.2%)。革兰阴性杆菌以铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌为主,分别占病原菌总数的17.6%、14.8%和11.5%;真菌以白色假丝酵母菌为主,占真菌总数的88.2%。药敏结果提示:革兰阴性杆菌均出现多重高比例耐药,白色假丝酵母菌对5-氟胞嘧啶、两性霉素B的敏感性较好,而对唑类药物出现强耐药性。结论:肺疾病患者下呼吸道感染病原菌以革兰阴性杆菌、真菌为主,而且出现多重耐药,临床宜根据药敏结果选择抗生素,并合理使用。

Objective： To explore the pathogen distribution and drug resistance on patients with lower respiratory tract infection, and guide clinical empirical anti-infective treatment. Methods： We retrospectively analyzed the pathogen and drug resistance in pulmonary disease patients＇ lower respiratory tract secretions from January 2007 to December 2008. Results： 567 strains were isolated, including 357 strains of Gram-negative bacilli （63.0%）, 186 strains of fungus （32.8%）, 24 strains of Gram-negative cocci （4.2%）. The most common Gram-negative bacilli were Pseudomonas aeruginosa （17.6%）, Klebsiella pneumonia （14.8%） and Escherichia coli （11.5%）. The major fungus was Candida albican （88.2% of fungi）. In our analysis, all strains of Gram-negative bacilli were multi-drug resistant bacteria. Candida albican had high sensitive- ness to 5-FU and Amphotericin B, but it showed very serious drug resistance to Azole. Conclusion： Gram-negative bacilli and fungus are the major pathogens in lower respiratory tract secretions. Antibiotics should be used reasonably according to drug resistance.