呼吸道感染主要病原菌分布及耐药性分析

Analysis of distribution and drug resistance of pathogenic bacteria in respiratory tract infections

目的 探讨呼吸道感染中主要病原菌的分布情况及耐药性分析,为临床合理选用抗菌药物提供实验室依据.方法 对2012年1月～2012年12月我院的1 120例合格痰标本进行常规培养、细菌鉴定药敏试验用BIOFOSUN微生物鉴定药敏分析系统的鉴定板条.结果 562株病原菌中革兰阴性杆菌422株（75.1％）,分别是克雷伯菌属152株（27.05％）、铜绿假单胞菌112株（19.93％）、大肠埃希菌84株（14.95％）、不动杆菌34株（6.05％）、肠杆菌属29株（5.16％）、嗜麦芽假单胞菌11株（1.96％）；革兰阳性球菌60株（10.67％）,分别是金黄色葡萄球菌23株（4.09％）、乙型链球菌18株（3.20％）、肺炎链球菌13株（2.31％）、肠球菌6株（1.07％）；真菌80株（14.23％）.结论 医院下呼吸道感染以革兰阴性杆菌为主,耐药率比较高,应根据药敏试验结果合理选用抗菌药物.

Objective To investigate the distribution and drug resistance of pathogenic bacteria in respiratory tract infec- tion so as to provide basis for rational use of clinical antibiotics. Methods 1 120 cases of qualified sputum specimens were cultured from January 2012 to December 2012 in our hospital. BIOFOSUN microbial identification and drug sensitivity analysis were adopted for identification of lath system automatic bacteria and drug sensitivity test. Results 422 strains of gram negative bacill （ 75.1% ） were identified in 562 strains of pathogenic bacteria. They were respectively 152 strains （ 27.05 % ） of Kleb- siella pneumoniae, 112 strains of pseudomonas aeruginosa（ 19.93% ） ,84 strains of Escherichia coli（ 14.95% ） ,34 strains of Acinetobacter（ 6. 05% ） ,29 strains （ 5.16% ） of enterobacter spp, and 11 strains （ 1.96% ） of pseudomonas maltophilia. 60 strains of gram-positive cocci （ 10.67% ） were detected. They were 23 strains of staphylococcus aureus （ 4.09% ） , 18 strains of streptococci（ 3.20% ） , 13 strains of streptococcus pneumoniae （ 2.31% ） , and 6 strains of enterococcus （ 1.07% ）. 80 strains of fungus （ 14.23% ） were found. Conclusion Nosocomial lower respiratory tract infection is mainly caused by gram- negative bacilli, which is characteristic of relatively high rate of drug resistance. Proper antibiotics should be chosen according to drug sensitivity test resuhs.