下呼吸道感染病原菌分布及耐药性分析

Distribution and Drug Resistance of Pathogenic Bacteria in Lower Respiratory Tract Infection

目的:探讨本地区下呼吸道感染常见病原菌分布与耐药情况,为临床合理选用抗生素提供参考。方法:选取本院2011年1月-2012年12月住院的下呼吸道感染患者的1603份合格标本,对痰培养分离出的病原菌进行鉴定和耐药分析。结果:1603份合格标本中共分离出病原菌819株,其中革兰氏阴性菌609株,占74.36%;革兰阳性球菌152株,占18.56%;真菌58株,占7.08%。其中5种致病菌依次为:大肠埃希氏菌、铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌,鲍曼不动杆菌,病原菌对各种抗菌药的耐药差异性较大,表现为多重耐药。在大肠埃希氏菌和肺炎克雷伯菌中检出产超广谱b内酰胺酶(ESBLs)的菌株率分别为51.77%(73/141)、40.68%(48/118);耐甲氧西林金黄色葡萄球菌(MRSA)检出率为41.12%(44/107)。结论:革兰阴性杆菌是下呼吸道感染的常见病原菌,最常见为大肠埃希氏菌;药敏结果表明耐药现象严重,产ESBL的菌株和MRSA的增加导致对多种抗生素耐药应引起重视,应加强病原菌检测及耐药性监测,合理使用抗菌药物,以减少耐药菌株产生。

Objective：To investigate lower respiratory tract infection common pathogens distribution and drug for clinical rational use of antibiotics reference in this region. Method：From January 2011 to December 2012,among hospitalized patients with lower respiratory tract infection sputum culture isolated pathogens were identified with drug analysis. Result：The 1603 qualified specimens,819 live bacteria were isolated,including gram-negative bacteria 609,accounting for 74.36%,Gram-positive cocci 152,accounting for 18.56%,fungi 58,accounting for 7.08%. Five kinds of bacteria were：Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae,Staphylococcus aureus,and Acinetobacter baumannii,pathogens resistant to various antibiotics differences were quite large and present multi-drug resistant. In Escherichia coli and Klebsiella pneumoniae produced ultra broad spectrum in the check b lactamase（ESBLs）strain rate were 51.77%（73/141）,40.68%（48/118）;Methicillin-resistant staphylococcus aureus（MRSA）detection rate was 41.12%（44/107）. Conclusion：Gram-negative bacilli are common. Susceptibility results shows that drug resistant is serious,and ESBL-producing strains of MRSA increase lead to multiple antibiotics,attention should be paid and pathogen detection and monitoring of drug resistance should be enhanced,with rational use of antimicrobial drugs to reduce drug-resistant strains.