下呼吸道感染病原菌分布及耐药性分析

Distribution and drug resistance of pathogens causing lower respiratory tract infections

目的了解下呼吸道感染菌群的分布特点及耐药性,指导临床合理选用抗菌药物。方法对诊断为下呼吸道感染的住院患者439份下呼吸道标本进行细菌学检查,采用VITEK-32全自动细菌鉴定系统和K-B纸片扩散法分别进行菌种鉴定及药敏试验。结果 439份痰标本分离出病原菌302株,以革兰阴性杆菌为主,占70.2%,革兰阳性球菌占22.2%;下呼吸道感染前5位病原菌依次为肺炎克雷伯菌、铜绿假单胞菌、鲍氏不动杆菌、大肠埃希菌、酿脓链球菌;分离出的病原菌对临床常用抗菌药物均呈现高比例耐药。结论下呼吸道感染以革兰阴性杆菌为主,耐药率较高,多药耐药现象普遍,临床宜根据药敏结果选择抗菌药物并合理使用。

OBJECTIVE To investigate the distribution and antimicrobial agent resistance of pathogens causing lower respiratory tract infections so as to guide the reasonable use of antibiotics.METHODS The bacteriological examination was carried out for 439 lower respiratory tract specimens for the hospitalized patients diagnosed as lower respiratory tract infections,the pathogens were identified by adopting VITEK-32 microbiological analysis system,at the same time,Kirby-Bauer（K-B） disk diffusion method was also applied to test the drug susceptibility.RESULTS There were 302 strains of pathogens isolated from 439 sputum specimens,among which gram-negative bacilli accounted for 70.2%,gram-positive cocci accounted for 22.2%;the top 5 pathogens causing lower respiratory tract infections were Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,Escherichia coli,and Streptococcus pyogenes,respectively;the isolated pathogens were highly resistant to commonly used antibiotics.CONCLUSION Gram-negative bacilli are the main pathogens causing lower respiratory tract infections,the drug resistance rate is high,multidrug-resistance is widespread,It is necessary to reasonably use antibiotics in accordance with the drug susceptibility testing.