下呼吸道混合感染病原菌耐药性分析

Analysis on the drug resistance of pathogenic bacteria of lower respiratory tract mixed infection

目的了解本院2011年下呼吸道混合感染病原菌耐药性,为临床合理用药提供参考。方法对本院2011年下呼吸道混合感染患者痰标本检出病原菌及耐药情况进行统计分析。结果本院下呼吸道多重感染病原菌以革兰阴性杆菌为主占65.5%,其次是革兰阳性球菌和真菌分别占14.1%和11.9%。最常见的菌种是铜绿假单胞菌、鲍曼不动杆菌、耐甲氧西林金黄色葡萄球菌、肺炎克雷伯菌、大肠埃希菌和白色假丝酵母菌。革兰阴性杆菌对抗菌药物敏感性较好的为亚胺培南、头孢哌酮/舒巴坦和哌拉西林/舒巴坦,肺炎克雷伯菌、大肠埃希菌对亚胺培南敏感率100%。非发酵菌对亚胺培南耐药性增强,尤其鲍曼不动杆菌对亚胺培南耐药率达51.7%。耐甲氧西林金黄色葡萄球菌对万古霉素未出现耐药现象。结论本院下呼吸道混合感染病原菌以革兰阴性杆菌为主,对多种抗菌药物的耐药率较高。真菌感染有上升趋势,临床应加强病原菌耐药监测和抗菌药物的合理使用。

Objective To investigate the drug resistance of pathogenic bacteria of lower respiratory tract mixed infection in our hospital in 2011 and to provide reference for clinically rational use of drugs.Methods The drug resistance of pathogenic bacteria from patients＇ sputum sample in our hospital in 2011 was analyzed statistically.Results First,among all the clinical isolated specimens,the gram-negative bacterium took up 65.5%,and the gram-positive bacterium and the fungus accounted for 14.1% and 11.9% respectively.The general bacteria were pseudomonsa aeruginosa,acinetobacter baumannii,methicillin-resistant staphylococcus aureus（MRSA）,klebsiella pneumoniae（KP）,escherichia coli（EC） and candida albicans.Imipenem,cefoperazone/sulbactam and piperacillin/sulbactam were more sensitive to the gram-negative.Klebsiella pneumoniae（KP） and escherichia coli（EC） were 100% sensitive to imipenem.Nonfermenters had stronger drug resistance to imipenem,especially acinetobacter baumannii which reached 51.7%.Methicillin-resistant staphylococcus aureus（MRSA） did not show drug resistance to vancomycin.Conclusion The major pathogenic bacteria of lower respiratory tract mixed infection are gram-negative which has high drug resistance.Hospital should enhance clinical microbiocogical test to promote rational use of antibacterial and reduce bacterial drug resistance.