摘要
目的探讨门诊患者呼吸道感染主要病原菌分布及其常用抗菌药物的使用情况。方法选取2010年1月-2014年1月门诊收治的829例呼吸道感染患者作为研究对象,将呼吸道黏膜作为标本进行分离、培养、鉴定,然后采用Kirby-Bauer（KB）法进行抗菌药物敏感性检测。结果 829例使用抗菌药物的呼吸道感染患者共提供痰和咽拭子标本1651份,分离培养出细菌568株（30.3%）,其中革兰氏阴性菌469株（81.1%）,革兰氏阳性菌67株（11.8%）,真菌42株（7.4%）。氧致病菌培养阳性率为34.4%。829例均有抗菌药物使用史,其中头孢菌素类368例（44.39%）,氨基糖苷类278例（33.53%）,大环内酯类66例（7.96%）。使用2种抗菌药物者276名（33.29%）,使用3种抗菌药物者69名（8.32%）。抗菌药物的平均使用天数2.74 d。铜绿假单胞菌对哌拉西林、环丙沙星耐药率较低,肺炎克雷伯菌对头孢噻肟、头孢哌酮耐药率较低,大肠埃希菌对头孢曲松、头孢哌酮耐药率较低,金黄色葡萄球菌对头孢唑林、氧氟沙星耐药率较低。结论门诊患者呼吸道感染的主要病原菌对于一些常用抗菌药物有不同的耐药性,应依据感染菌种药敏试验的分析结果选用抗菌药物,细菌学检查是合理选用抗菌药物和减少细菌耐药的最佳方法。
Objective To explore the main distributions of pathogenic bacteria in outpatient’s respiratory tract infection and application of common antimicrobial agents. Methods 829 outpatients with respiratory tract infection from January 2010 to January 2014 in outpatient clinic were selected as the research object,the mucosa of respiratory tract as speci-mens were separated,cultured and identified,then tested for sensitivity of antibacterial agents by Kirby-Bauer （KB） method. Results There were 1651 sputum and throat swab specimens from 829 patients with respiratory tract infection treated by antibacterial agents.568 strains of bacteria were separated and cultured,and the positive rate was 30.3%. There were Gram-negative bacteria in 469 strains accounting for 81.1%, 67 strains of Gram-positive bacteria for 11.8%,and 42 strains of fungi accounting for 7.4%.The positive rate of pathogenic bacterium was 34.4%.829 partici-pants had medical history of using antibacterial drugs,cephalosporins were used in 368 cases （44.39%）,aminoglycosides were used in 278 csaes（33.53%）,macrolides were used in 66 csaes（6.51%）.There were 276 patients using two kinds of antimicrobial agents and took the percentage of 33.29% in all patients with acute respiratory tract infection.There were 69 patients using 3 kinds of antimicrobial agents accounting for 8.32%in all patients with acute respiratory tract infec-tion.The average time of using antibacterial agents lasted 2.74 d.The drug resistant rates of Pseudomonas aeruginosa on ciprofloxacin and ciprofloxacin was relatively low,the drug resistant rates of Klebsiella pneumonia on cefotaxime and cefoperazone was relatively low, the drug resistant rates of Escherichia coli on ceftriaxone and cefoperazone was rela-tively low,the drug resistant rates of Staphylococcus aureus on cefazolin and levofloxacin was relatively low. Conclusion The main pathogenic bacteria of outpatient’s respiratory tract infection have different drug-resistance on some common antibacterial agents.Selection o
出处
《中国当代医药》
2015年第14期148-150,共3页
China Modern Medicine
关键词
门诊
呼吸道感染
病原菌
分布
抗菌药物
耐药性
Outpatient clinic
Respiratory tract infection
Pathogenic bacteria
Distribution
Antimicrobial agents
Drug resistance
