摘要
目的了解医院肺部感染致病菌分布及其耐药性,指导临床治疗。方法对临床收集的2636份合格痰标本进行分离培养及药敏试验。结果总共分离培养出1032株病原菌,其中革兰阳性细菌312株,占30.2%,社区获得性下呼吸道感染247株,医院获得性下呼吸道感染65株,常见病原菌依次为表皮葡萄球菌(表葡菌)、肺炎链球菌、金黄色葡萄球菌、肠球菌,对青霉素类、大环内酯类、克林霉素等耐药严重,平均达60%～70%,对万古霉素敏感性仍高,平均耐药率低于3%;革兰阴性细菌720株,占69.8%,社区获得性感染559株,医院获得性感染161株,常见病原菌为铜绿假单胞菌、鲍曼不动杆菌、肠科杆菌、肺炎克雷伯菌。与社区感染菌株相比,院内感染菌株对大部分抗生素耐药严重,平均达70%￣80%,仅对头孢哌酮-舒巴坦、美洛培南仍较敏感。各革兰阴性菌产ESBLs百分率均低于20%。结论表葡菌所占比例特别高是本组革兰阳性细菌的显著特点。革兰阳性菌对大部分抗生素耐药严重,仅对万古霉素仍保持高敏感性。院内感染革兰阴性菌株耐药率明显高于院外感染菌株。产ESBLs菌株对大部分抗生素呈多重耐药性。
[Objective] To investigate the distribution and resistance to antibiotics of 1032 isulated pathegens from patients with pulmonary infection. [Methods] Bacteria isolates and their resistance to antibiotics were taken on 2636 sputum spemcimen from patients with pulmonary infection. [Results] The 1032 strains were found from the 2636 sputum spemcimen. Among them 312（30.2%） strains were Gram-positive bacilli（GPB）, the outstanding pathegens were Staphycoccus epidermidis, Streptococcus pneumoniae, Staphylococcus aureus, Enterococcus. The resistance rates to penicillin, macrolides and Clindamycin were very high, ranging from 60% to 70%, the resistance rate to Vancomycin was the lowest, being 3%. The 720（69.8%） strains were Gram-negative bacilli（GNB）, the outstanding pathegens were Pseudomonas aeruginosa, Acinetobacter baumanni, Enterobacteriaceae, Klebsiella pneumoniae. Comparing with pathegenic strains of community acquired lower respiratory tract infection, the resistance rates to antibiotics of nosoeomiu acquired lower respiratory tract infection pathogenic strains were markly higher, being 70%- 80%, just keeping high sensibility to Cefoperazone-Sulbactam and Meropenem. The percentages of ESBLs in strains of Gram-negative bacilli were less than 20%. [Conclusion] Staphycoccus epidermidis was predominant organism responsible for infection in GPB. The resistance rates to antibiotics of GPB were very high, except to Vaneomycin. The resistance rates to antibiotics for nosocomiu acquired infection pathogenic strains were marldy higher than that of community acquired infection pathogenic strains. The strains of ESBLs were multi-resistant.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2005年第18期2851-2854,2856,共5页
China Journal of Modern Medicine
关键词
肺部感染
致病菌分布
耐药性
pulmonary infection
bacterium distribution
antimicrobial resistance
