某院呼吸道感染细菌的分布及耐药性分析

Analysis of Bacterial Distribution and Drug Resistance of Respiratory Tract Infection in a Hospital

目的为指导临床合理用药,控制院内感染提供准确的参考数据。方法对该院2015年1月—2017年12月该院送检590例呼吸道感染患者的痰及咽拭子标本进行鉴定及药敏试验,应用WHONET 5.6及WPS Office 2016表格进行统计分析。结果共分离出261株病原菌,革兰阳性菌占19.5%,革兰阴性菌占80.5%。常见菌分别为铜绿假单胞菌、肺炎克雷伯菌、嗜麦芽寡养单胞菌、大肠埃希菌、奇异变形杆菌金黄色葡萄球菌等。大肠埃希菌和肺炎克雷伯菌产β-内酰胺酶(ESBLs)的检出率分别为47.2%和26.9%,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为70.7%,发现1株耐万古霉素的金黄色葡萄球菌。铜绿假单胞菌对阿米卡星高度敏感;嗜麦芽寡养单胞菌对左氧氟沙星保持敏感,肠杆菌科对碳青霉烯类、ESBLs抑制剂复合剂和阿米卡星敏感,金黄色葡萄球菌对万古霉素、利奈唑胺、米诺环素及氯霉素敏感。结论临床应根据该院细菌分布特点和药物敏感试验结果,选取合理治疗方案,避免耐药菌株的出现。

Objective To provide accurate reference data for guiding rational drug use and controlling nosocomial infections.Methods The specimens of sputum and throat swabs from 590 patients with respiratory infections from the hospital from January 2015 to December 2017 were identified and tested for drug susceptibility. The WHONET 5.6 and WPS Office 2016 tables were used for statistical analysis. Results A total of 261 strains of pathogenic bacteria were isolated. Gram-positive bacteria accounted for 19.5% and Gram-negative bacteria accounted for 80.5%. Common bacteria are Pseudomonas aeruginosa, Klebsiella pneumoniae, Stenotrophomonas maltophilia, Escherichia coli, Proteus mirabilis, and the like. The detection rates of β-lactamases（ESBLs） produced by Escherichia coli and Klebsiella pneumoniae were 47.2% and 26.9%, respectively. The detection rate of methicillin-resistant Staphylococcus aureus（MRSA） was 70.7%. 1 Staphylococcus aureus resistant to vancomycin. Pseudomonas aeruginosa is highly sensitive to amikacin; Stenotrophomonas maltophilia is sensitive to levofloxacin; Enterobacteriaceae is sensitive to carbapenems, ESBLs inhibitor complexes and amikacin, golden yellow grapes Cocci were sensitive to vancomycin, linezolid, minocycline, and chloramphenicol. Conclusion According to the characteristics of bacterial distribution and drug sensitivity test in the hospital, a reasonable treatment plan should be selected to avoid the emergence of resistant strains.