痰标本中肠杆菌科细菌的筛查与药敏分析

The Screening and Drug Sensitivity Analysis of Enterobacteriaceae Bacteria in Sputum Specimens

目的:通过对痰标本中的细菌进行菌种鉴定以及药敏试验,筛查引起呼吸道感染的主要菌株,同时通过分析药敏试验结果,为临床合理选择用药提供依据。方法:沈阳医学院奉天医院2011年8月至11月临床各科送检的合格痰标本159例,经过革兰染色及分离培养等初步鉴定后,将肠杆菌科细菌经细菌鉴定仪进行菌种鉴定,同时采用K-B法对其进行药物敏感试验。结果:从159例痰标本中共分离鉴定出61株肠杆菌科细菌,其中肺炎克雷伯菌的检出率最高(33/61,54.1%),其次是大肠埃希菌(21/61,34.4%)。药敏试验结果显示,上述两种细菌均对β-内酰胺/β-内酰胺抑制剂复合物和头孢类药物具有较强的耐药性,对亚胺培南较敏感。结论:肺炎克雷伯菌和大肠埃希菌是导致呼吸道感染的常见菌株,临床治疗首选亚胺培南。目前临床上多重耐药现象普遍,应引起重视,加强抗生素合理使用,提高临床治愈率。

Objective： To screen principle strains inducing respiratory tract infection through identification of the bacteria isolated from sputum specimens of patients. Result analysis of drug sensitive test on these strains can provide evidences for clinical reasonable medication. Methods： One hundred and fifty-nine sputum specimens delivered from clinical departments of Fengtian hospital diffiliat- ed to Shenyang Medical College were initially identified through separation culture and Gram stain. The strains of Enterobacteriaceae were then identified with ATB and performed drug sensitivity test in vitro with K-B method. Results： Sixty-one strains of Enterobacte- riaceae were isolated and identified from sputum specimens, among which the detection rate of Klebsiella pneumoniae was highest （33/61, 54. 1% ）, next was E. eoli （21/61, 34. 4% ）. The results of drug sensitivity test showed that both bacteria possessed stronger drug resistance to beta-laetam/beta-lactam inhibitor compound and cephalosporines, while sensitive to imipenem. Conclu- sions ： Klebsiella pneumoniae and E. coli were common strains inducing respiratory tract infection and imipenem was first-choice drug for clinical treatment. Therefore, muhidrug resistant phenomenon was generally in clinic and should be paied more attention. Antibi- otics should be rationally used to raise clinical recovery rate.