下呼吸道感染常见病原菌检测及耐药性分析

Detection and Drug Resistance Analysis of Common Pathogenic Bacteria in Lower Respiratory Tract Infection

目的了解下呼吸道常见病原菌感染构成及耐药性,为临床合理使用抗菌药物提供实验依据。方法对2009年1月—2010年5月在内蒙古医学院附属人民医院住院及门诊下呼吸道感染患者合格痰标本进行细菌学培养,细菌鉴定采用法国生物梅里埃公司API-20 E检定系统及常规手工法,用K-B法做药敏检测。结果共分离到652株致病菌,其中革兰阴性杆菌523株(80.2%),主要以肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、阴沟肠杆菌、弗劳地枸橼酸杆菌多见。革兰阳性菌129株(19.8%),主要以金黄色葡萄球菌和假丝酵母菌多见。药敏结果显示,革兰阴性杆菌除铜绿假单胞菌外,亚胺培南耐药率最低(0%);最高为氨苄西林(均值84.2%)。金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)分离率较高(68.5%),MRSA除万古霉素外显示多重耐药。结论该院下呼吸道感染以革兰阴性杆菌为主,不同的细菌对同一抗菌药物有不同的敏感性,应根据药敏实验结果合理选择抗菌药物,减少病原菌耐药性的产生。

[ Objective] To understand composition and drug resistance of common pathogenic bacteria in lower respiratory tract infection, provide the experimental basis for rational use of antibiotics in clinic. [ Methods] Bacterial culture was conducted on qualified sputum specimen from inpatients and outpatients with lower respiratory tract infection in People＇s Hospital Affiliated to Inner Mongolian Medical College from January 2009 to May 2010. API-20E identification system of France Biomerieux and routine manual method were adopted to the bacteria identification. Drug sensitivity test was conducted by K-B method. [ Results ] 652 strains of path- ogenic bacteria were isolated. There were 523 （ 80.2% } strains of Gram-negative bacilli, which mainly included Klebsiella pneu- moniae, Escherichia coli, Pseudomonas aeruginosa, Enterobacter cloacae and Citrobacter freundii. There were 129（ 19.8% ） strains of Gram-positive bacteria, which mainly included Staphylococcus aureus and Candida albicans. The drug sensitivity test showed： except Pseudomonas aeruginosa, the resistance rate of Gram-negative bacilli to imipenem was the lowest （ 0% ） , and the resistance rate to ampicillin was the highest （ mean value was 84.2% ）. Among Staphylococcus aureus, the isolation rate of Methieillin-resistant Staphylococcus aureus （MRSA） was high （68.5%）, and MRSA showed multi-drug resistance except for vancomycin. [ Conclusion ] The pathogenic bacteria of lower respiratory tract infection in this hospital are dominated by Gram-negative bacilli, and the sensitivity of different bacteria to same antibiotic is different. The antibiotic should be chosen according to the results of drug sensitivity test, so as to reduce the antibiotic resistance in pathogenic bacteria.