肺部感染病原菌谱及耐药性分析

Bacterial spectrum of pathogens causing pulmonary infections and their drug resistance

目的了解医院肺部感染病原菌构成及耐药性,为临床治疗肺部感染合理选择抗菌药物提供指导。方法采集医院172例肺部感染患者的痰标本,合格标本接种至血平板、巧克力平板、麦康凯平板进行细菌培养,细菌分离培养与鉴定参考《全国临床检验操作规程》进行,药敏试验采用纸片扩散法。结果 172例患者痰标本分离出148株病原菌,其中革兰阴性杆菌94株占63.51%,革兰阳性球菌32株占21.62%,真菌22株占14.87%;革兰阴性杆菌对氨苄西林耐药率最高,除嗜麦芽寡养单胞菌外,对亚胺培南敏感性最高;革兰阳性球菌对万古霉素的耐药率均为0。结论革兰阴性菌为医院肺部感染的主要致病菌,且细菌的耐药性较严重,临床医师应根据药敏结果合理应用抗菌药物。

OBJECTIVE To explore the pathogens causing pulmonary infections and their drug resistance so as to provide guidance for reasonable use of antibiotics to treat the pulmonary infections. METHODS The sputum specimens were sampled from 172 patients with pulmonary infections. The qualified specimens were inoculated to blood agar plate, the chocolate plate, and the MacConkey tablet for the bacterial culture. The isolation and identification of the bacteria were performed by referring to the National Clinical Laboratory Test Standards, and the drug susceptibility testing was performed by disc diffusion method. RESULTS A total of 148 strains of pathogens were isolated from the sputum specimens of 172 patients, including 94 （63. 51%） strains of gram-negative bacilli, 32 （21.62%） strains of gram-positive cocci,and 22 （14.87%） strains of fungi. The resistance rates of the gram-negative bacilli to ampicillin were the highest, the gram-negative bacilli were most suseptibl to imipenem except for Stenotrophomonas maltophilia. The drug resistance rates of the gram-positive cocci to vancomycin were 0% The susceptibility of gram-negative bacteria to imipenem were highest; The resistance rate of gram-positive bacteria to vancomycin were 0%. CONCLUSION The gram-negative bacteria are the main pathogens of pulmonary infections in the hospital, the drug resistance of which are severe, thus the clinicians should reasonably use antibiotics on the basis of the drug susceptibility testing.