呼吸道感染痰培养的病原菌分布及其耐药分析

Distribution and drug resistance of pathogens cultivated from sputum in respiratory tract infections

目的:了解呼吸道感染患者的痰培养病原菌分布及其耐药性,指导临床合理用药。方法:采集2009年1月-2010年12月疑似呼吸道感染的患者的痰标本进行细菌分离培养、鉴定和药敏试验,并分析其病原学分布及对抗生素的耐药性。结果:6744份痰标本分离病原菌2236株,其中革兰阴性(G-)菌1526株,占68%;革兰阳性(G+)菌177株,占8%;真菌534株,占24%。以铜绿假单胞菌、鲍曼不动菌、大肠埃希菌、金黄色葡萄球菌和肺炎克雷伯菌为主要细菌。G+球菌对万古霉素、米诺环素较为敏感,而G-杆菌对美洛培南和亚胺培南的敏感性较高。结论:常见细菌耐药性有上升趋势,且具有多重耐药性。在治疗感染性疾病时应进行病原学检查,依据药敏试验结果合理使用抗生素,以减少耐药菌株产生。

Objective：In order to conduct the clinical use of antibiotics rationally,distribution and drug resistance of pathogens cultivated from sputum in respiratory tract infections（RTIs） were analyzed.Methods：The pathogens cultivated from sputum of the RTIs patients from January 2009 to December 2010 were identified and obtained susceptibility testing.Then their Distribution and drug resistance were analyzed.Results：A total of 2236 strains were isolated from 6744 samples,of which Gram-positive（G＋） bacteria accounted for 8%（177）,Gram-negative（G-）bacteria accounted for 68%（1526） and fungi accounted for 24%（534）.The majority of pathogens were Pseudomonas aeruginosa,Acinetobacter baumannii,Escherichia coli,Staphylococcus aureus and klebsiella pneumoniae.Gram-positive bacteria were sensitive to vancomycin and Minocycline,While Gram-negative bacteria were sensitive to Meropenem and Imipenem.Conclusion：The drug resistance rate was increasing and many pathogens were multi-resistance.In order to reduce drug resistance strains in infectious diseases,it is important to use the antibiotics rationally according to the susceptibility testing.