345株下呼吸道感染革兰阴性杆菌的分布及耐药

Distribution and drug resistance of 345 strains gram negative bacilli from hospitalized patients with lower respiratory tract infections diseases

目的了解院内下呼吸道感染革兰阴性杆菌的状态，供临床用药借鉴。方法院内下呼吸道感染患者痰菌分离，经培养鉴定共取得３４５株革兰阴性杆菌。抗生素敏感性测定采用ＫＢ纸片法，最低抑菌浓度（ＭＩＣ）采用琼脂二倍稀释法。β内酰胺酶的测定采用Ｎｉｔｒｏｃｅｐｈｉｎ纸片法，超广谱β内酰胺酶（ＥＳＢＬｓ）测定采用Ｅｔｅｓｔ法。结果（１）克雷伯菌属及铜绿假单胞菌在３４５株细菌中分别占３９７％、１７４％。（２）头孢噻肟耐药率由４２９％（６年前）降至８２％。（３）ＥＳＢＬｓ检测结果为阴性。结论（１）克雷伯菌属及铜绿假单胞菌构成院内下呼吸道感染主要致病菌。（２）尚未发现ＥＳＢＬｓ的存在。

Objective To investigate the distribution and drug resistance of gram negative bacilli in respiratory ward. Method (1) Drug resistance was tested by Kirby Bauer disk sensitivity method and MIC by agar doubling dilution. (2) β lactanase was tested by nitrocephin. (3) ESBLs was tested by E test. Result (1)Among 345 strains gram negative bacillus, klebsiella pneumoniae and pseudomonas aeruginoea was about 39.7%, 17.4%, respectively. (2) Drug resistance rate of cefotaxime dropped from 42.9% (6 years ago) to 8.2%. (3) β lactamase positive rate of 345 strains bacilli was 54.5%. (4) ESBLs was negative. Conclusion (1) Klebsiella pneumoniae and pseudomonas aerugries were the main pathogens in lower respiratory tract infection in hospital. (2) Although we didn′t find the evidence of ESBLs, we should pay more attention to it in the future.