医院获得性下呼吸道感染病原菌分布与耐药性分析

Analysis of pathogenic bacteria distribution and drug resistance of hospital-acquired lower respiratory infections

目的了解医院获得性下呼吸道感染病原菌分布,分析其耐药性,为临床治疗提供参考。方法收集2013年1月-2014年1月在医院诊治的3 744例下呼吸道感染患者作为研究对象,采集患者痰液标本进行细菌培养、病原菌鉴定和药物敏感试验,并采用SPSS18.0软件进行统计分析。结果 3 744份痰液标本培养出病原菌936株,分离率25.00%,其中以革兰阴性菌为主,共683株占72.97%,居前3位依次为铜绿假单胞菌、肺炎克雷伯菌,对亚胺培南的耐药率最低,分别为0.75%、2.65%;鲍氏不动杆菌对妥布霉素的耐药率最低,为4.12%;检出革兰阳性菌169株占18.06%,主要为金黄色葡萄球菌,其对万古霉素、利奈唑胺和莫西沙星耐药性最低,分别为0、0和8.16%。结论医院获得性下呼吸道感染的常见病原菌主要为革兰阴性菌,革兰阴性菌对亚胺培南、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦具有较高的敏感性。

OBJECTIVE To investigate distribution and drug resistance of pathogens for hospital‐acquired lower re‐spiratory infections so as to provide reference for clinical treatment .METHODS Totally 3 744 patients suffering from lower respiratory infections treated in hospital between Jan .2013 and Jan .2014 were collected as the sub‐jects .Sputum samples were collected from patients with lower respiratory infection to perform bacteria culture , pathogen identification and drug sensitivity test . The software SPSS18 .0 was used for statistical analysis . RESULTS In the 3 744 sputum samples ,936 clinical isolates were obtained （the separation rate 25 .00% ） ,mainly including 683 strains of gram negative bacteria （72 .97% ） ,followed by Pseudomonas aeruginosa and K lebsiella pneumoniae ranking the top three .P .aeruginosa and K .pneumoniae had the lowest resistances of 0 .75% and 2 .65% to imipenem .Acinetobacter baumannii had the lowest resistance of 4 .12% to tobramycin .Totally 169 strains of gram positive bacteria （18 .06% ） were detected ,mainly including Staphylococcus aureus with the lowest resistances of 0 ,0 and 8 .16% respectively to vancomycin ,linezolid and moxifloxacin .CONCLUSION Gram nega‐tive bacteria are the major pathogenic bacteria causing hospital‐acquired lower respiratory infection .The gram neg‐ative bacteria have relatively high resistance to imipenem ,piperacillin/tazobactam and cefoperazone/sulbactam .