下呼吸道感染病原菌分布及药敏分析

Distribution and drug susceptibility analysis of lower respiratory tract infection pathogens

目的探讨下呼吸道感染病原菌分布特点以及药敏率,以期为临床指导合理用药提供参考依据。方法对2011年1月-2012年12月诊治的68例下呼吸道感染患者进行前瞻性监测与回顾性调查,并对下呼吸道感染患者进行痰培养及病原菌鉴定,采用纸片扩散法检测抗菌药物的敏感性。结果医院诊治4 000例患者中发生下呼吸道感染者68例,感染率为1.70%;68例下呼吸道感染患者送检的痰标本中共分离出病原菌76株,其中革兰阴性杆菌48株占63.16%,革兰阳性球菌23株占30.26%,真菌5株占6.58%;革兰阴性杆菌对环丙沙星、左氧氟沙星和阿米卡星的敏感率均>60.0%,革兰阳性球菌对氨苄西林的敏感率为64.82%。结论下呼吸道感染患者病原菌分布以革兰阴性杆菌为主,应加强病原菌培养及药敏监测,合理选用抗菌药物治疗,对指导临床用药具有重要意义。

OBJECTIVE To explore the distribution characteristics and drug susceptibility of the lower respiratory tract infection pathogens, and to provide a reference for the rational clinical use of drugs. METHODS The prospective monitoring and retrospective investigation were conducted on 68 cases of patients with lower respiratory infection treated in the hospital from Jan. 2011to Dec. 2012. The phlegm cultivation and identification of pathogen species were performed on patients with lower respiratory tract infections, and the sensitivity to antimicrobial drugs was detected by disc diffusion method. RESULTS Among the 4000 cases of patients treated in our hospital, 68 patients developed lower respiratory tract infections, with the infection rate of 1.70% ; 76 strains of pathogens were isolated in sputum specimens of 68 cases of patients with lower respiratory tract infections, of which 48 strains of gram negative bacteria（63.16 %）, 23 strains of gram positive bacteria（30.26 %）, 23 strains of fungi（6. 58%） were detected. The overall susceptibility rates of the gram-negative bacilli to ciprofloxacin, levofloxacin, and amikacin were more than 60.0%, and the drug susceptibility rate of the gram-positive cocci to ampicillin was 64.82 %. CONCLUSIONS Gram-negative bacteria is the main pathogen in the lower respiratory tract infection pathogens. The pathogen culture and drug susceptibility monitoring should be strengthened for the rational choice of antimicrobial drugs, and is of great significance to guide the clinical medication.