206例肺部感染患者痰培养革兰阴性杆菌药敏情况分析

Analysis of Gram-negative bacilli's medical resistance on 206 patients with lung infected through phlegm germiculture

目的 :了解近年肺部感染的细菌种类及革兰阴性杆菌对抗生素的药敏情况 ,以期指导临床合理用药。方法 :用法国生物墨里埃细菌诊断系统 (ATB)对 2 0 6例肺部感染患者的痰液作细菌培养及药物敏感试验 ,分析革兰阴性杆菌的药敏情况。结果 :致病菌生长 118株 ( 5 7 2 8% ) ,其中革兰阳性球菌 3 1株 ( 2 6 2 7% ) ,革兰阴性杆菌 87株 ( 73 73 % )。革兰阴性杆菌的药敏情况为 :亚胺培南 90 80 %、哌拉西林 +他唑巴坦 71 2 6%、氨基糖苷类 64 3 7%、喹诺酮类 45 41%、单纯 β 内酰胺类 3 3 62 %、磺胺类 2 0 69%。前三者的药物敏感率明显高于后三者 (P <0 0 1)。结论 :近年来随着抗生素的广泛应用 ,院外感染革兰阴性杆菌的比例逐渐升高。由于抗生素的不合理使用 ,大部分革兰阴性杆菌对喹诺酮类、单纯 β 内酰胺类及磺胺类抗生素耐药 ,对亚胺培南和β 内酰胺类 + β

AIM: After we know the categories of bacteria infecting the lung in recent years and the properties of the Gram-negative bacilli's medical sensitivity to antibiotics, it can guide us to use medicine more correctly in clinical use. METHODS: By means of the bioMérieux sa France Bacterial Diagnosing System (ATB), we analyzed the Gram-negative bacilli's medical sensitivity through the phlegm germiculture and the medical sensitivity's test on 206 patients with their lungs infected. RESULTS: There were 118 cases (57.28%) that were illness-causing bacterial growth, 31 cases (26.27%) of which belonged to Gram-positive coccus, and 87 (73.73%) belonged to Gram-negative bacilli. The properties of Gram-negative bacilli's medical sensitivity were as follows: imipenem 90.80%, piperacillin+tazobactam 71.26%, aminoglycosides 64.37%, quinolone 45.41%, pure β-lactam 33.62%, sulfonamide 20.69%. The medical sensitivity properties of the first 3 were apparently higher than those of the last 3 (P<0.01). CONCLUSION: With antibiotics widely used in recent years, the Gram-negative bacilli infected outside hospitals is increasing. Because of the incorrect use of antibiotics, most of the Gram-negative bacilli have antibiotics resistance on quinolone. Pure β-lactam and sulfonamide and so on, but they are also sensitive to imipenem, the β-lactam+β-lactammases (BAL) inhibitions and the aminoglycosides antibiotics.