下呼吸道感染患者痰培养结果及病原菌耐药性分析

Sputum culture of pathogens causing lower respiratory tract infections and analysis of drug resistance

目的探讨下呼吸道感染患者常见病原菌分布特点及其耐药性分析的临床价值。方法回顾性分析5917例住院患者的痰培养结果及主要病原菌的药敏资料。结果下呼吸道感染病原菌以革兰阴性菌为主,占65.43%;前3位依次为肺炎克雷伯菌、铜绿假单胞菌、醋酸钙不动杆菌;肺炎克雷伯菌对氨苄西林耐药率为100.00%,对头孢哌酮/舒巴坦和亚胺培南比较敏感,耐药率分别为1.58%、6.96%;铜绿假单胞菌对四环素、磺胺甲噁唑/甲氧苄啶、氯霉素、氨苄西林、阿莫西林/克拉维酸、头孢唑林、氨苄西林/舒巴坦、头孢噻肟耐药率均为100.00%,对头孢哌酮/舒巴坦、多黏菌素敏感性较好,耐药率分别为1.19%、1.98%;醋酸钙不动杆菌对氨苄西林、氨曲南、阿莫西林/克拉维酸、头孢唑林耐药率均为100.00%,对头孢哌酮/舒巴坦完全敏感,对多黏菌素的耐药率仅为1.37%;鲍氏不动杆菌对氨苄西林、氨曲南、阿莫西林/克拉维酸、头孢唑林、哌拉西林耐药率均为100.00%,对头孢哌酮/舒巴坦、多黏菌素完全敏感。结论下呼吸道感染与细菌耐药性有关,合理使用抗菌药物,延缓细菌耐药性对降低医院感染有重要意义。

OBJECTIVE To investigate the distribution and drug resistance of the common pathogens causing lower respiratory tract infections.METHODS The sputum culture result for 5917 hospitalized patients as well as the drug susceptibility of the main pathogens was retrospectively analyzed.RESULTS Gram-negative bacteria were the main pathogens causing lower respiratory tract infections,accounted for 65.43%;the top three species were Klebsiella pneumonia,Pseudomonas aeruginosa,and Acinetobacter calcium acetate,respectively.The drug resistance rate of K.pneumonia to ampicillin was 100.00%,1.58% to cefoperazone/sulbactam,and 6.96% to imipenem.The drug resistance rates of P.aeruginosa to tetracycline,chloramphenicol,ampicillin,sulfamethoxazole/trimethoprim,amoxicillin/clavulanic acid,cefazolin,ampicillin/sulbactam,and cefotaxime were all 100.00%,1.19% to cefoperazone/sulbactam,and 1.98% to polymyxin.The drug resistance rates of A.calcium acetate to ampicillin,aztreonam,amoxicillin/clavulanic acid,cefazolin were all 100.00%,0 to cefoperazone/sulbactum,and 1.37% to polymyxin.The drug resistance rates of A.baumannii to ampicillin,aztreonam,amoxicillin/clavulanic acid,cefazolin,and piperacillin were 100.00%,with 0 to cefoperazone/sulbactam and polymyxin.CONCLUSION The lower respiratory tract infections are related to the bacterial drug resistance,it is of great significance in reducing the incidence of nosocomial infections to use antibiotics reasonably and delay the bacterial resistance.