探讨呼吸道感染苛养菌分布及耐药特点

Bacterial flora distribution and drug resistance of fastidious bacteria in the respiratory tract infection

目的探讨呼吸道苛养菌分布及耐药特点,为临床治疗提供依据。方法收集整理2010年1月至2012年12月从呼吸道感染疾病患者痰液标本细菌培养资料共512例,对资料进行综合分析。结果 512例呼吸道感染疾病患者痰液标本总共分离出苛养菌572株,其中产超广谱β-内酰胺酶(ESBLs)率最高的是卡他莫拉菌[52.9%(74/140)],未发现对青霉素中介或耐药的肺炎链球菌。卡他莫拉菌、流感嗜血杆菌、副流感嗜血杆菌和肺炎链球菌对第三代头孢类抗菌药物的敏感率在80.0%以上;卡他莫拉菌和肺炎链球菌对阿莫西林/克拉维酸的敏感率为100.0%,流感嗜血杆菌和副流感嗜血杆菌对阿莫西林/克拉维酸的敏感性分别为91.2%和89.6%;流感嗜血杆菌对克拉霉素的敏感率最高(89.1%);4种苛养菌对四环素的敏感率偏低;卡他莫拉菌、流感嗜血杆菌、副流感嗜血杆菌对复方磺胺甲恶唑的耐药率偏高。结论第三代头孢类抗菌药物对由苛养菌引起的呼吸道感染具有很强的抗菌能力,临床上应该依据药敏试验结果,为合理使用抗菌药物提供保障,提高治愈率。

Objective To explore the bacterial flora distribution and drug resistance of fastidious bacteria in the respiratory tract infection,and so as to provide reference for clinical treatment. Methods Fastidiious bacteria isolated from sputum of patients with respiratory tract infection from January 2010 to December 2012 were collected,and the results were analyzed comprehensively. Re- suits 572 cases of fastidious bacteria were isolated from 512 patients, the highest rate of ESBLs production was Moraxelle ca- tarrhalis （ MC;52.9 %, 74/140）, and penicillin resistant streptococcus pneumonia （SP） isolates was not found. The susceptibility rates of MC,HI,HP and SP {or the third generation cephalosporin antibiotic were all more than 80%. The susceptibility rates of MC, HI, HP and SP for the amoxicillin/clavulanic acid were 100.0 %, 91.2 %, 89.6%, and 100.0%, respectively. The highest rate of HI for the clarithromycin was 89.1 %. The susceptibility rates of 4 kinds of fastidious bacteria for the tetracycline were low. The resistance rates of MC, HI and HP for the sulfamethoxazole were high. Conclusion The third generation cephalosporin antibi- otic has strong activity against fastidious bacteria caused respiratory tract infection. We should rationally use antibiotics according to the results of susceptibility testing for improving the cure rate.