下呼吸道感染革兰氏阴性杆菌的耐药性分析

Analysis of Drug Resistance with Gram-negative Bacilli of Lower Respiratory Tract Infection

目的 了解下呼吸道感染革兰氏阴性杆菌的种类并对其药敏结果进行分析,为临床合理使用抗生素提供依据.方法 对451医院2009年1月～2010年3月820例下呼吸道感染患者的痰标本进行常规细菌培养,利用全自动微生物鉴定系统VITEK 2 COMPACT对培养出的纯菌株进行鉴定和药敏试验.结果 489株病原菌中革兰氏阴性杆菌345株,占70.6%,前五位分别是肺炎克雷伯菌肺炎亚种（ESBLs28.6%）占30.4%,大肠埃希氏菌（ESBLs49.0%）占14.8%,阴沟肠杆菌占12.2%,铜绿假单胞菌占11.3%,鲍曼不动杆菌占7.0%;药敏结果显示,美罗培南、亚胺培南耐药率很低,氨苄西林、哌拉西林、头孢唑啉、头孢呋辛钠、头孢呋辛酯耐药率很高.结论 革兰氏阴性杆菌不同菌种对同一抗菌药物敏感差异较大,应根据药敏结果选择抗生素以减少耐药菌株的产生.

objective To investigate the distribution of G-regative isolated from patients with lower respiratory tract infection and analyse drug-sensitivity,provide reference for rational use of agents in clinics. Methods A total of 820 sputum samples of patients with lower repiratory tract infection in 451 hospital from january 2009 to march 2010 were identified and the drug resistance tests were performed using VITEK 2 COMPACT system. Results 345 strains of Gram-negative bacilli isolated from 489 strains of bacteria were accounted for 70.6%. The main Gramnegative bacilli were Klebsiella pneumoniae （ESBLs28.6%） 30. 4%, Escherichiacoli （ESBLs49.0%） 14.8%, Enterobactercloacae 12- 2%, Pseudomonasaeruginosa 11.3% and Baumanii 7.0%. The resistance rates of Gram-negative bailli to meropenem,imipenem were relatively low. The resistance rates of Gram-negative bailli to ampicillin,piperacillin,eefazolin,cefuroxime-sodium and cefuroxime-aaxeril were very high. Conclusion For the same antimicrobial agent,different bacteria has a different sensi- tivity. Selected the antibiotic according to the results of drug sensitivity test and reduce production of bacteria resistant to drugs.