摘要
目的 了解普通病房下呼吸道感染病原菌谱及耐药性。方法 对1990 ~1996 年间下呼吸道感染住院患者合格痰标本行细菌学培养,阳性菌以KB 法或2 倍稀释法行药物敏感测定。结果 ①6 228 个痰标本中分离细菌2 660 株,阳性率为39 .29 % ,其中以革兰阴性细菌为主,占70 .75 % 。绿脓杆菌、不动杆菌、肺炎杆菌、表皮葡萄球菌、金黄色葡萄球菌居分离菌前5 位,分离率分别为18 .08 % 、15 .6 % 、11 .73% 、9 .66 % 、4 .96 % 。②药敏结果提示绿脓杆菌、不动杆菌、黄杆菌、D 群非肠球菌出现多重高比例耐药。革兰阴性杆菌对头孢塞甲羧肟、伊米配能、氨基甙类、喹诺酮类较为敏感。革兰阳性菌则对万古霉素高度敏感。结论 近年院内感染的下呼吸道感染以革兰阴性杆菌为主,出现多重耐药。应根据药敏结果选择抗生素,必要时联合应用。
Objective To realize the bacterial spectrum and drug resistance in the lower respiratory tract infections of inpatients in the general wards. Methods Qualified sputum specimens from inpatients with lower respiratory tract infections between June 1990 and June 1996 were cultured for bacterial isolation, and the antimicrobial sensitivity tests were determined by K B methods or agar dilution methods. Results ① Among the two thousand and six hundred sixty strains, mostly (70.75%) were Gram negative bacilli, isolated from 6228 sputum speciments, the isolating rate was 39.29%. The 5 most common isolated bacteria were Pseudomonas aeruginosa, Acinetobacter, Klebsiella, Staphylococcus epidermis and Staphlococcus aureus, with isolating rates of 18.1%, 15.6%, 11.7%, 9.7% and 5.0%, respectively. ② Except all the Staphylococcus spp were sensitive to vancomycin, all the other isolated strains showed resistance to all the agents tested at varying levels, also multidrug resistance emerged, Imipenem, Ceftazidime, Amikacin and Ciprofloxacin were relatively active against the gram negative bacilli. Conclusion In recent years, gram negative bacilli have become the major pathogens in lower respiratory tract infections with high multidrug resistance. Selection of sensitive antibiotics should base on the drug sensitivity tests, and combination use may be necessary. (Shanghai Med J, 1999,22∶673 676)
出处
《上海医学》
CAS
CSCD
北大核心
1999年第11期673-676,共4页
Shanghai Medical Journal
关键词
下呼吸道感染
病原菌谱
耐药性
医院感染
Lower respiratory tract infection Bacterial spectrum Antimicrobial susceptibility test