2010—2012年阳新县人民医院下呼吸道感染病原菌的分布及耐药性分析

Analysis on distribution and drug resistance of pathogenic bacteria in lower respiratory tract infection in Yangxin People's Hospital from 2010 to 2012

目的分析阳新县人民医院下呼吸道感染病原菌的分布及耐药性,为有效控制医院感染和指导临床合理使用抗菌药物提供可靠的依据。方法对2010—2012年住院下呼吸道感染患者痰标本中分离的病原菌分布及其耐药情况进行回顾性统计分析。结果送检的3 961份痰标本中检出1 394株病原菌(35.2%),其中革兰阴性菌966株(69.3%),主要包括鲍氏不动菌、铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌;革兰阳性菌134株(9.6%),以金黄色葡萄球菌为主;真菌294株(21.1%),主要为白假丝酵母菌。药物敏感试验显示,除真菌耐药率较低外,革兰阴性菌中鲍氏不动菌、铜绿假单胞菌对头孢呋辛和氨苄西林具有较高的耐药性;革兰阳性球菌对青霉素的耐药率达100.0%。结论下呼吸道感染患者感染的病原菌以铜绿假单胞菌和肺炎克雷伯菌等革兰阴性菌为主,且主要的致病菌对常用抗菌药物耐药情况显著,应对该病原菌分布的一系列变化及耐药性给予高度重视,以及时指导临床合理选择抗感染药物和减少耐药株的产生。

Objective To analyze the distribution and drug resistance of pathogenic bacteria in lower respiratory tract infection in Yangxin People＇s Hospital, so as to provide the reliable evidence for the infection control and rational selection of clinical drugs. Methods The distribution of bacteria and antibiotic sensibility in Yangxin People＇s Hospital from 2010 to 2012 was reviewed, retrospectively. Results A total of 1 394 swains of pathogens were isolated from 3 961 eligible sputum specimens with the detection rate of 35.2%, including 966 （69.3%） strains of Gram-negative bacilli among which Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumonia were dominant. Gram-positive bacilli were 134 strains （9.6%） and Staphylococcus aureus was dominant; Fungi were 294 strains （21.1%） and Candida albicans was dominant. Drug sensitivity test showed that, in addition to fungal resistance rates, Gram-negative bacteria including A. bacterium and P. aeruginosa had higher resistance to cefuroxime and ampicillin. Resistance rate of Gram-positive bacteria to penicillin was 100.0%. Conclusion The bacterial infection in the hospitalized patients with lower respiratory tract infections is mainly Gram-negative bacilli, including P. aeruginosa and K. pneumonia, which have the serious drug resistance to commonly used antibiotics. Changes of pathogen distribution and drug resistance should be given more attention to guide the reasonable clinical application of antibiotics and reduce drug resistant strains.