我院呼吸内科下呼吸道感染病原菌的分布及其体外耐药性监测分析

Analysis of bacterial distribution and surveillance of drug resistance in vitro of lower respiratory tract infection in department of respiratory medicine in our hospital

目的：监测齐鲁石化中心医院（以下简称“我院”）呼吸内科住院患者下呼吸道感染病原菌分布及体外耐药情况，为临床抗生素药物的合理应用及呼吸道疾病的有效治疗提供一定的理论依据。方法回顾性分析2012年1月～2014年12月我院呼吸内科下呼吸道感染住院患者的临床资料，对其痰液培养阳性的病原菌菌株的分布及体外药敏试验结果进行分析。结果在我院呼吸内科住院患者的近3年的统计结果显示，下呼吸道感染菌群分布中革兰阴性菌由2012年的30株逐渐升高到2013年的35株、2014年的83株，2013、2014年的感染比例明显高于2012年，三年间革兰阴性菌种感染分布经字2检验差异有高度统计学意义（χ2=14.630，P=0.003）。革兰阳性菌种感染的比例呈降低趋势，2013、2014年的感染比例明显低于2012年，三年间革兰阳性菌种感染分布经字2检验差异有高度统计学意义（χ2=16.741，P=0.000）。体外药物敏感试验结果显示，导致感染的3种主要革兰阴性菌及2种主要革兰阳性菌对大部分抗生素有不同程度的耐药现象。结论本地区下呼吸道感染病原菌的耐药情况较为普遍，研究下呼吸道感染菌群的分布及监控药敏试验结果能为临床肺部感染疾病的诊治及抗生素药物的选择、合理应用提供较为可靠的证据，降低临床耐药新菌株的产生。

Objective To monitor the bacterial distribution and drug resistance in v itro of lower respiratory tract infec-tion in Department of Respiratory Medicine in Qilu Shihua Central Hospital （“our hospital”for short）, to provide certain theoretical basis for clinical reasonable application of antibiotics and effective treatment of respiratory diseases. Meth-ods The clinical data of lower respiratory tract infection in Department of Respiratory Medicine in our hospital from January 2012 to December 2014 were analyzed retrospectively, the sputum culture positive strains of bacterial pathogens distribution and drug susceptibility in v itro test results were analyzed. Results In our hospital of hospitalized patients with respiratory medicine for nearly three years of statistics, according to the results of the lower respiratory tract infection, the gram-negative bacteria flora distribution were increased from 30 strains of 2012 to 83 strains of 2014 and 35 strains of 2013 step by step, difference of three years gram-negative bacterial infection distribution tested by chi-square was highly significant （χ2=14.630, P=0.003）. The proportion of gram-positive bacteria infection showed a trend of decrease in 2013, 2014, which were significantly lower than the proportion of infection in 2012, difference of three years distribution of gram-positive bacteria infection tested by chi-square was highly significant （χ2=16.741, P=0.000）. Drug sensitivity test in v itro showed that, according to the results of the three main gram-negative bacteria and two main gram-positive bacteria infection had different levels of resistance to most antibiotics. Conclusion The drug resistance of lower respiratory tract infection pathogens in this region is relatively common. The study on the infection of lower respiratory tract bacterial flora distribution and monitoring drug susceptibility test results can provide a reliable evidence for the clinical diagnosis and treatment of pulmonary infection diseases and the choice of antibiotics, the rea-sonable application of new strains of clinical drug resistance, which can reduce the new strains of clinical drug resis-tance.