呼吸道感染革兰阴性杆菌及其耐药性研究

RESEARCH ON DRUG RESISTANCE OF GRAM- NEGATIVE BACILLI CAUSING RESPIRATORY INFECTIONS

目的研究医院住院患者呼吸道感染革兰阴性杆菌特点及其耐药情况。方法通过回顾性调查方法,对绍兴市人民医院2011-2012年住院患者下呼吸道感染革兰阴性杆菌情况进行了调查与分析。结果连续两年时间内从住院下呼吸道感染病人标本中共分离出革兰阴性杆菌4 512株,排在前5位的分别是铜绿假单胞菌(26.3%)、肺炎克雷伯菌(26.1%)、鲍曼不动杆菌(22.7%)、大肠埃希菌(4.6%)、嗜麦芽窄食单胞菌(4.3%)。鲍曼不动杆菌对常用抗生素的耐药率超过了50%,铜绿假单胞菌和肺炎克雷伯菌耐药率低于前者,大肠埃希菌对碳青霉烯类抗生素的敏感率超过90%。结论住院病人下呼吸道感染病原菌主要是革兰阴性杆菌,耐药较严重的菌株是鲍曼不动杆菌,必须引起重视。

Objective To study the bacterial characteristic and drug resistance of respiratory infections with Gram - negative bacilli in hospital inpatients. Methods A retrospective survey method was used to analyze the data from the patients with lower respiratory tract infections during year 2011 to 2012. Results A total of 4 512 Gram - negative bacilli were isolated from the patients with lower respiratory tract infections in two years. The top 5 of isolating strains were Pseudomonas aeruginosa（ 26. 3% ）, Klebsiella pneumoniae （ 26. 1% ）, Acinetobacter baumanii （ 22. 7% ）, Escherichia coli （ 4. 6% ）, Pseudomonas maltophilia （4. 3% ）. The resistance rate of A. baumannii to commonly used antibiotics was over 50%, but the resistance rates of P. aeruginosa and K. pneumoniae were lower than that of the former. The sensitivity rate of E. coli to Carbapenems antibiotics was more than 90%. Conclusion The Gram - negative bacilli is the mainly pathogens in lower respiratory tract infections in inpatients and the drug resistance of A. baumannii strains is more serious. So we should pay more attention to it.