G^+杆菌下呼吸道感染的细菌学分类及抗生素耐药性分析

BACTERIAL CLASSIFICATION AND DRUG RESISTANCE OF GRAM-NEGATIVE BACILLIC IN LOWER RESPIRATORY TRACT INFECTION

目的 :探讨 G-杆菌下呼吸道感染的细菌学分类情况及抗生素耐药性特点。方法 :利用复星公司FOUTUNE.IMS细菌鉴定药敏分析系统。结果 :30～ 6 0岁年龄组与 >6 0岁年龄组的痰培养阳性率、G- 杆菌比例、葡萄球菌比例差异无显著性 ;>6 0年龄组真菌的比例较 30 - 6 0年龄组为高 (P<0 .0 5 ) ;两组 G- 杆菌各菌属比例差异无显著性 ;119株 G- 杆菌共分离出埃希菌属、肠杆菌属、克雷伯菌属、沙雷菌属、变形杆菌属、不动杆菌属和假单胞菌属等 7个菌属的细菌 ;G- 杆菌总耐药率由高到低依次为氨苄西林 (77.3% )、头孢唑林 (74 .8% )、哌拉西林 (5 3.8% )、青霉烷砜 (48.7% )、头孢呋辛 (46 .3% )。结论 :>6 0岁组下呼吸道感染仍以 G-杆菌为主要致病菌 ,真菌跃居第二位 ,其次为葡萄球菌。G-杆菌分离出的 7个菌属对青霉素、一代头孢菌素、二代头孢菌素均呈较高的耐药率 ,对氨基甙类、喹诺酮类、三代头孢菌素、氨曲南相对敏感。

Objective: To investigate the bacterial classification and drug-resistance of Gram-negative bacillic in lower respiratory tract infection.Methods:A Fuxing company-made FOUTUNE.IMS automatic bacteria identification and drug sensitivity analyser was adopted.Results: No significant difference of the positive percentage of bacteria in sputum culture.The incidence of Gram-negative bacillic and Staphylicoccus was seen between 30～60 years old group and >60 years old group.The incidence of fungus and spore of fungus was increasing significantly in >60 years old group as compared with 30～60 years old group.The incidence of every genus in Gram-negative bacillic has no difference between the two group above mentioned. Seven genera seperated from 119 gram-negative bacillic stains were Escherichia,Enterobacter,Klebsiella,Serratia,Acinetobacter and Pseudomonas .Drug resistance of gram-negative bacillic to ampicillin,cephazolin,piperacillin,sulbactam and cefuoxime was 77.3%,74.8%,53.8%,48.7% and 46.3% respectively.Conclusions: The predominant pathogeus in lower respiratory tract infection was Gram-negative bacillic in >60 years old group and was followed by fungus,spore of fungus and Staphylococcus .Drug resistance total rates of the seven genera seperated from Gram-negative bacillic from high to low was penicillin,the first and second gereration cephalosporine,but to aminoglycosides,quinolones,the third generation cephalosporine and aztreonam the bacteria were sensitive.