下呼吸道感染病原菌分布及耐药分析

Distribution and Drug Resistance of Pathogens in Lower Respiratory Tract Infection

目的:分析我院下呼吸道感染病原菌分布及药敏结果,指导临床合理用药。方法:统计我院近5年下呼吸道感染病原菌送检阳性标本17833份,分析病原菌分布及耐药性。结果:下呼吸道感染排前五位的细菌依次为铜绿假单胞菌(28.04%)、嗜麦芽寡养单胞菌(16.65%)、鲍曼不动杆菌(14.55%)、肺炎克雷伯菌(12.28%)、金黄色葡萄球菌(7.56%)。排前五位的真菌依次为白色念珠菌(52.59%)、热带念珠菌(15.72%)、光滑念珠菌(10.17%)、非白念珠菌(8.51%)、近平滑念珠菌(4.62%)。铜绿假单胞菌对头孢噻肟、替加环素、米诺环素,嗜麦芽寡养单胞菌对亚胺培南、美罗培南,鲍曼不动杆菌对头孢噻肟,金黄色葡萄球菌对青霉素G、阿莫西林耐药率均达90%以上。肺炎克雷伯菌对环丙沙星、氨曲南、多西环素耐药率达70%以上。结论:对感染铜绿假单胞菌避免使用头孢噻肟、替加环素、米诺环素。感染嗜麦芽寡养单胞菌避免使用亚胺培南、美罗培南。感染鲍曼不动杆菌避免使用头孢噻肟。感染金黄色葡萄球菌避免使用青霉素G、阿莫西林。

Objective:To analyze the distribution and drug sensitivity of pathogens of lower respiratory tract infection in our hospital,and to guide rational drug use in clinic.Methods:A total of 17833 positive specimens of lower respiratory tract infection in our hospital in recent 5 years were collected,and the distribution and drug resistance of pathogens were analyzed.Results:The top five bacteria of lower respiratory tract infection were Pseudomonas aeruginosa(28.04%),oligotrophomonas maltophil(16.65%),Acinetobacter baumannii(14.55%),Klebsiella pneumoniae(12.28%),Staphylococcus aureus(7.56%).The drug resistance rates of Pseudomonas aeruginosa to cefotaxime,tigecycline and minocycline,oligotrophomonas maltophil to imipenem and meropenem,Acinetobacter baumannii to cefotaxime,Staphylococcus aureus to penicillin G and amoxicillin were all over 90%.The resistance rate of Klebsiella pneumoniae to ciprofloxacin,aztreonam and doxycycline was more than 70%.Conclusion:Cefotaxime,tigecycline and minocycline should be avoided for Pseudomonas aeruginosa infection.Avoid using imipenem and meropenem for infection of oligotrophomonas maltophilia.Avoid cefotaxime for Acinetobacter baumannii infections.Avoid penicillin G and amoxicillin for Staphylococcus aureus infection.