革兰阴性杆菌性肺炎的病原菌分布及耐药性监测

Pathogenic distribution and antimicrobial resistance of Gram-negative bacillus causing pneumonia

目的探讨医院革兰阴性杆菌性肺炎的病原菌构成比及耐药性,为抗感染治疗寻求科学依据。方法对345例革兰阴性杆菌性肺炎患者的痰及下呼吸道分泌物培养结果进行回顾性调查,对分离细菌菌谱和药物敏感试验结果进行统计分析。结果培养出的387株革兰阴性杆菌中,分离率居前5位的依次为铜绿假单胞菌(28.2%)、肺炎克雷伯菌(19.9%)、鲍氏不动杆菌(14.5%)、大肠埃希菌(12.7%)、嗜麦芽寡养单胞菌(8.3%);5种重要病原菌均显示出严重的耐药性,铜绿假单胞菌和鲍氏不动杆菌泛耐药菌株检出率达16.5%、19.6%。结论呼吸内科医师务必做好肺炎患者的细菌学检查,按照药敏结果进行抗感染治疗。

OBJECTIVE To study the constituent ratio and drug resistance of gram-negative bacillus causing pneumonia so as to explore the scientific evidence of anti-infective treatment. METHODS A retrospective review was performed for 345 strains of gram negative bacillus from the sputum and lower respiratory tract secretion of patients with pneumonia.The bacterium spectrum and drug susceptibility testing results were statistically analyzed. RESULTS Among 387 isolates of gram-negative bacilli,the top five isolation rates were as the following： Pseudomonas aeruginosa（28.2%）,Klebsiella pneunmoniae（19.9%）,Acinetobacter baumannii,（14.5%）,Escherichia coli（12.7%）,Stenotrophomonas maltohpilia,（8.3%）.The five important pathogens all showed serious drug resistance.The detection rates of pan-resistant PAE and ABA reached to 16.5% and 19.6%. CONCLUSION The clinicians in department of respiratory diseases should prescribe the antibiotics according to bacteriological testing and susceptibility testing results of patients with pneumonia.