下呼吸道多重耐药菌感染相关因素及耐药状况分析

Related factors and drug-resistance' s analysis of lower respiratory tract multi-drug resistant infection

目的了解下呼吸道感染多重耐药菌的易感因素、病原菌分布及耐药性,为预防和控制多重耐药菌株产生提供依据。方法选取我院呼吸内科186例下呼吸道感染住院患者,分为MDRB感染组和非MDRB感染组,分析MDRB易感因素、病原菌分布及耐药性。结果易感因素包括住院时间、吸烟、院内感染、基础疾病、有创操作及使用多种广谱抗菌药物等。67株多重耐药菌前5位为鲍曼不动杆菌、肺炎克雷伯菌肺炎亚种、铜绿假单胞菌、大肠埃希菌、金黄色葡萄球菌。耐药性分析结果显示:鲍曼不动杆菌对头孢西丁、头孢呋辛耐药率最低(分别为9.1%、13.6%);肺炎克雷伯菌和大肠埃希菌对亚胺培南/西司他汀耐药率最低(均为0);铜绿假单胞菌对阿米卡星、亚胺培南/西司他汀耐药率最低(均为9.1%);金葡菌对万古霉素、利奈唑胺、替考拉宁耐药率为0%。结论应加强对下呼吸道感染病原菌的监测与控制,根据药敏结果合理选用抗生素,以减少耐药菌株产生。

Objective To investigate the susceptible factors, distribution and drug resistance of lower respir- atory tract multi-drug resistant infection. Methods 186 patients with lower respiratory tract infection in our hospital were divided into the MDRB group and the non-MDRB group. The susceptible factors, pathogen distribution and drug resistance of the MDRB group were analyzed. Results The susceptible factors included duration of hospital stay, smoking, nosocomial infections, basic diseases, invasive operation and use of a variety of broad-spectrum antibiotics. The top five bacteria in 67 strains of multiple drug resistant bacteria were Bauman Acinetobacter, Klebsiella pneu- moniae, Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus. Drug resistance analysis showed that the resistance of Bauman Acinetobacter to cefoxitin and cefuroxime was the lowest （ respectively 9.1% , 13.6% ）, the re- sistance of Klebsiella pneumoniae and Escherichia coli to imipenem/cystatins was the lowest （both 0）, the resistance rate of Pseudomonas aeruginosa to amikacin and imipenem/cystatins was the lowest （ both 9. 1% ）, and the resistance of Staphylococcus aureus to vancomycin linezolid and teicoplanin was 0%. Conclusion It is necessary to strengthen the monitoring and control of pathogenic bacteria in lower respiratory tract infection, according to the drug sensitivity results to reduce the generation of drug resistant strains.