下呼吸道感染病原菌分布及耐药性分析

Analysis of distribution and drug resistance of pathogens in lower respiratory tract infection

目的:了解我院呼吸科住院病人下呼吸道感染的病原菌分布情况及其耐药特点。方法:应用ATB细菌鉴定及药敏分析仪,对2007～2008年度呼吸科临床送检标本中分离的菌株进行鉴定和药敏感性检测。结果:共分离出253株致病菌,其中革兰阴性菌111株(43.87%),真菌99株(39.13%),革兰阳性菌43株(17%)。耐药分析显示主要革兰阴性菌对碳青酶烯类抗生素敏感性最高;主要真菌对两性霉素B(100.00%)、伏力康唑(99.42%)、5-氟胞嘧啶(96.85%)以及氟康唑(63.52%)均较敏感。结论:下呼吸道感染病原菌中真菌所占比例越来越大,临床应合理应用抗生素,为减少医源性二重感染以及细菌耐药性的发生。

Objective ：To investigate the distribution and drug resistance of pathogens isolaled from the patients with lower respiratory tract infection to provide reference for rational drug use in clinic. Methods：Tim isolated strains from all the specimens in our hospital from Aug. 2007 to Jul.2008 were identified by ATB bacteria identification system,and the drug sensitivity analysis was carried out. Results：Totally 253 strains of bacteria were isolated, the dominants were the Gram-negative bacilli （43.87%）,among which Pseudomonas aeruginosa was 12.65% ,Klebsiella pneumoniae subsp.pneumoniae was 9.49% ,Escherichia Coli was 5.93% ,Acinetobacter baumannii was 3.95% and Stenotrophomonas mahophilia was 3.95%.The second pathogens were fungi （39.13%）,among which Candida albicans was 22.53%,Candida glabtats was 9.09% and Candida tropicalis was 5.14%.The Gram-positive bacteria （17%） were the lowest ones,among which Staphylococcus aureus was 4.74% and Staphylococcus heamolyticus was 4.35%. The results of drug sensitivity tests indicated that carbapenems were the most sensitive to most Gram-negative bacilli except Stenotrophomonas maltophilia（0%）.Amphotericin B ,fluconacole and 5-fluorouridine were all quite sensitive to most fungi. Conclusion：Fungi are taking more and more big part of the pathogens.Rational use of antibiotics is important to reduce iatrogenic super infection and occurrence of drug resistance.