社区获得性肺炎226例呼吸道深处痰液标本病原菌学及药敏试验结果分析

Analysis of Gacteriological and Drug Sensitivity Test Results of 266 Sputum Samples from Deep Respiratory Tract of Community Acquired Pneumonia

目的:调查社区获得性肺炎(CAP)患者呼吸道深处痰液标本病原菌分布情况,并分析其药敏试验结果。方法:选取郑州市第九人民医院2018年1月至2020年10月CAP患者226例作为研究对象,收集其痰液进行细菌培养并分析其耐药性。结果:226例CAP患者共检出218株病原菌,其中革兰阴性菌检出145株,占比66.51%,革兰阳性菌检出57株,占比26.15%。在所检出革兰阳性菌中,肺炎链球菌占比最高为10.55%(23/218);在所检出革兰阴性菌中,肺炎克雷白杆菌占比最高为15.14%(33/218)。在革兰阳性菌耐药性分析中,肺炎链球菌对万古霉素、利奈唑胺敏感率最高均为100.00%(23/23);金黄色葡萄球菌和表皮葡萄球菌均对利奈唑胺敏感率最高为100.00%(12/12)。在革兰阴性菌耐药性分析中,肺炎克雷伯杆菌、大肠埃希菌、铜绿假单胞菌均对亚胺培南敏感率最高为100.00%(33/33);而鲍曼不动杆菌对头孢曲松敏感率最高为96.30%(26/27)。结论:CAP患者呼吸道深处痰液标本中病原菌复杂多样,但主要以革兰阴性菌为主,依据病原菌种类、分布和耐药性特点合理选择治疗方案,有助于提升治疗效果,促进患者早日康复。

Objective:To investigate the distribution of pathogenic bacteria in sputum samples from deep respiratory tract of patients with community-acquired pneumonia(CAP),and to analyze the results of drug susceptibility test.Methods:226 cases of CAP patients in Zhengzhou Ninth People's Hospital from January 2018 to October 2020 were selected as research subjects.Their sputum was collected for bacterial culture and drug resistance was analyzed.Results:A total of 218 strains of pathogenic bacteria were detected in 226 CAP patients,among which 145 strains of Gram-negative bacteria were detected,accounting for 66.51%and 57 strains of Gram-positive bacteria were detected,accounting for 26.15%.Among the gram-positive bacteria,Streptococcus pneumoniae accounted for 10.55%(23/218).Klebsiella pneumoniae accounted for 15.14%of gram-negative bacteria(33/218).In the analysis of drug resistance of gram-positive bacteria,Streptococcus pneumoniae had the highest sensitivity rate of 100.00%to vancomycin and linezolid(23/23).The sensitivity rate of both S.aureus and S.epidermidis to linezolid was 100.00%(12/12).Among gram-negative bacteria,Klebsiella pneumoniae,Escherichia coli and Pseudomonas aeruginosa were all susceptible to imipenem with the highest sensitivity rate of 100.00%(33/33).The highest sensitivity rate of Acinetobacter baumannii to ceftriaxone was 96.30%(26/27).Conclusion:The pathogens in the sputum samples in the deep respiratory tract of CAP patients are complex and diverse,but mainly Gram-negative bacteria.Reasonable selection of treatment regimens based on the species,distribution and drug resistance characteristics of the pathogens is helpful to improve the treatment effect and promote the early recovery of patients.