2951例患者痰培养结果及耐药性分析

Sputum culture results of 2951 inpatients and drug resistance

目的了解痰培养病原菌的分布特点及耐药情况,为临床合理使用抗菌药物提供依据。方法对2951例住院患者的痰标本进行培养及药敏分析,并对革兰阴性杆菌进行ESBLs的检测。结果 2009年痰培养共计2951例,检出病原菌2111株,检出率71.5%,革兰阴性杆菌占58.0%,其中前3位的有大肠埃希菌、肺炎克雷伯菌和鲍氏不动杆菌,革兰阳性菌占17.9%,以金黄色葡萄球菌、表皮葡萄球菌为主,真菌占24.1%;革兰阴性杆菌对常用的抗菌药物有不同程度的耐药,产ESBLs菌以大肠埃希菌和肺炎克雷伯菌为主,发生率分别为39.1%和36.3%;革兰阳性菌对万古霉素、替考拉宁普遍敏感,耐甲氧西林葡萄球菌占葡萄球菌属的45.6%,真菌对抗真菌药物均敏感。结论痰培养的主要病原菌是革兰阴性杆菌,随着病程的发展对常用抗菌药物耐药性呈上升趋势,因此痰培养和药敏分析对指导临床更加合理性用药具有重要意义。

OBJECTIVE To investigate the distribution of pathogenic bacteria and drug resistance,to provide the clinical basis for the rational use of antimicrobial agents.METHODS A total of 2951 cases of hospitalized patients in sputum samples were cultured and drug sensitivity analysis was performed,and Gram-negative bacilli producing ESBLs were detected.RESULTS In 2009,among 2951 cases of sputum culture,totally 2111 strains of pathogens were detected,with the detection rate of 71.5%.G-bacilli accounted for 58.0%,of which the top three were Escherichia coli,Klebsiella pneumoniae and Acinetobacter spp.G＋ bacteria accounted for 17.9%,which were mainly the Staphylococcus aureus and Staphylococcus epidermidis.Fungi accounted for 24.1%.G-bacteria to showed different degrees of resistance to commonly used antibiotics.ESBLS-producing E.coli bacteria and K.pneumoniae were the main bacteria with the incidence rates of 39.1% and 36.3%,respectively.G＋ bacteria generally sensitive to vancomycin,teicoplanin,MRS accounted for 45.6% of S.aureus,fungi were sensitive to antifungal agents.CONCLUSION The main pathogens from sputum culture are Gram-negative bacteria,with the course developing,the drug resistance is increasing,so the sputum culture and drug sensitivity analysis have great significance for the rational use of antibiotics in clinics.