下呼吸道感染患者病原菌分布与耐药性分析

Distribution and drug resistance analysis of pathogens causing lower respiratory tract infections

目的探讨下呼吸道感染患者病原菌分布及耐药性,为临床合理用药提供依据。方法对2013年1-12月358例下呼吸道感染患者痰标本分离的病原菌分布及耐药性进行分析,细菌鉴定及药敏试验采用法国生物梅里埃公司全自动细菌鉴定及药敏分析系统,研究数据采用WHONET5.4软件进行处理。结果 358例下呼吸道感染患者痰标本共分离病原菌208株,其中革兰阴性菌140株占67.31%,革兰阳性菌29株占13.94%,真菌39株占18.75%;铜绿假单胞菌对氨苄西林/舒巴坦、磺胺甲噁唑/甲氧苄啶耐药率分别为76.47%、67.65%,鲍氏不动杆菌对氨苄西林、头孢唑林、呋喃妥因耐药率分别为100.00%、96.43%、92.86%,肺炎克雷伯菌对头孢呋辛、氨苄西林/舒巴坦、哌拉西林的耐药率分别为68.00%、64.00%、64.00%;金黄色葡萄球菌对青霉素的耐药率>95.00%。结论了解患者下呼吸道感染的病原菌分布及耐药性,可指导临床合理使用抗菌药物,对控制医院感染具有重要意义。

OBJECTIVE To investigate the distribution and antimicrobial agent resistance of pathogens causing lower respiratory tract infections in hospital so as to guide the reasonable use of antibiotics .METHODS Totally 358 pa‐tients with hospital‐acquired pneumonia who were treated in the hospital from Jan .1 ,2013 to Dec .31 ,2013 were enrolled in the study .The sputum specimens were collected from these patients ,then the identification of patho‐gens and the drug susceptibility testing were performed by the full automatic bacterial identification system and drug susceptibility analyzer made by BioMerieux ,France .WHONET 5 .4 was applied for the data analysis . RESULTS Totally 208 strains of pathogens have been isolated from 358 inpatient sputum samples ,including 140 （67 .31% ） strains of gram‐negative bacteria ,29 （13 .94% ） strains of gram‐positive bacteria and 39 （18 .75% ） strains of fungi .The drug resistance rates of the Pseudomonas aeruginosa to ampicillin/sulbactam ,sulfamethox‐azole/trimethoprim were 76 .47% and 67 .65% ;the drug resistance rates of the Acinetobacter baumannii to ampi‐cillin ,cefalotin ,nitrofurantoin were 100% ,96 .43% and 92 .86% respectively ;the drug resistance rates of the K lebsiella pneumoniae to cefuroxime ,ampicillin/sulbactam and peracillin were 68 .00% ,64 .00% and 64 .00% re‐spectively .The drug resistance rate of Staphylococcus aureus to penicillin were over 95% .CONCLUSION Investi‐gating the distribution and antimicrobial agent resistance of pathogens causing lower respiratory tract infections can guide the reasonable use of antibiotics .It is significant to reduce the incidence of hospital‐acquired pneumonia .