河南省某三级医院204例呼吸道感染患者病原体检测结果及耐药性分析

Pathogen detection results and drug susceptibility analysis of 204 patients with respiratory tract infection in a tertiary hospital in Henan Province

目的了解河南省某三级医院呼吸道疾病患者病原体分布及药物敏感情况,为临床诊断和选用抗生素提供参考。方法2020年5月至2022年5月收集河南省新郑市某三级医院204例呼吸道感染患者的痰液或肺泡灌洗液,常规接种、分离、鉴定,对阳性病原菌进行药物敏感程度检测。所得数据使用SPSS 26.0软件进行统计分析。结果204例呼吸道疾病患者呼吸道标本共分离出病原菌77株,其中革兰阴性菌58株(75.32%),革兰阳性菌4株(5.19%),真菌15株(19.48%)。病原检出前4位依次是流感嗜血杆菌(22株,28.57%)、肺炎克雷伯菌(14株,18.18%)、白色念珠菌(14株,18.18%)、铜绿假单胞菌(11株,14.29%)。病原菌多重耐药率为8.06%(5/62)。药敏试验结果显示,肺炎克雷伯菌对头孢噻肟、替卡西林/克拉维酸、氨曲南、复方新诺明、头孢吡肟的耐药率均<15.00%;铜绿假单胞菌对头孢他啶、哌拉西林、哌拉西林/他唑巴坦耐药率均<20.00%,对亚胺培南、替卡西林/克拉维酸、氨曲南、头孢吡肟的耐药率均<10.00%;肺炎链球菌对阿奇霉素、红霉素、克林霉素、四环素、复方新诺明的耐药率较高(均为100.00%);白色念珠菌对卡泊芬净的耐药率较高(21.43%)。结论革兰阴性菌是该三级医院呼吸道感染患者的主要病原菌,且耐药程度低。

Objective To provide the reference for clinical diagnosis and selection of antibiotics by understanding the pathogen distribution and drug susceptibility of patients with respiratory diseases in a tertiary hospital in Henan Province.Methods The sputum or alveolar lavage fluid of 204 patients with respiratory tract in a tertiary hospital in Xinzheng County of Henan Province from May 2020 to May 2022 were collected.The routine inoculation,isolation,identification,and drug susceptibility test to positive pathogens were conducted.SPSS 26.0 software was used for statistical analysis.Results A total of 77 pathogenic bacteria were isolated from the 204 patients with respiratory tract diseases,including 58 Gram-negative bacteria(75.32%),four Gram-positive bacteria(5.19%)and 15 fungi(19.48%).The top four pathogens with frequent detection were Haemophilus influenae(22 strains,28.57%),Klebsiella pneumoniae(14 strains,18.18%),Candida albicans(14 strains,18.18%)and Pseudomonas aeruginosa(11 strains,14.29%).The rate of multi-drug resistance was 8.06%(5/62).The resistance rates of Klebsiella pneumoniae to cefotaxime,ticacillin/clavulanate,amtronam,cotrimoxazole and cefepime were all lower than 15.00%.The drug resistance rates of Pseudomonas aeruginosa to ceftazidime,piperacillin,piperacillin/tazobactam were all lower than 20%,and the drug resistance rates to imipenem,ticacillin/clavulanate,amtraxam and cefepime were all lower than 10.00%.The resistance rates of Streptococcus pneumoniae to azithromycin,erythromycin,clindamycin,tetracycline and cotrimoxazole were high(all 100.00%).The resistance rate of Candida albicans to carpofungine was relatively high(21.43%).Conclusions Gram-negative bacteria were the main pathogenic bacteria in patients with respiratory tract infection in this tertiary hospital in Henan province,and the degree of drug resistance was low.