摘要
目的:了解青岛市立医疗集团下呼吸道感染病原菌的分布及耐药特点,为临床医生合理使用抗菌药物提供理论依据。方法:对2012年1月-2013年12月下呼吸道感染患者各类标本分离出的病原菌进行培养,采用VITEK-2全自动细菌鉴定仪进行菌种鉴定及药敏试验,双纸片扩散法进行ESBLs的确证试验。结果:分离鉴定的1 252株病原菌主要来源于呼吸内科(57.8%)、ICU(15.3%)、神经内科(13.5%)及神经外科(12.1%)。革兰阴性杆菌783株占62.5%,革兰阳性球菌418株占33.4%;真菌51株占4.1%。产ESBLs大肠埃希菌和肺炎克雷伯菌检出率分别为56.4%和38.7%。革兰阴性杆菌对青霉素类及一代、二代头孢菌素耐药性较高,对亚胺培南等高度敏感,且产酶菌株的耐药率明显高于非产酶菌株。金黄色葡萄球菌除对万古霉素和替考拉宁高度敏感,对其他抗生素耐药率较高。结论:下呼吸道感染分离的病原菌以革兰阴性杆菌为主,且存在多重耐药现象,应引起临床医生的高度重视。
Objective：To understand the distribution and drug resistance of pathogenic bacteria causing lower respiratory tract infections in Qingdao Municipal Hospital（Group）and provide evidence for the rational use of antimicrobial drugs.Methods：The pathogenic bacteria were cultured from a variety of specimens obtained from the lower respiratory tract infection patients between Jan 2012 and Dec 2013 in Qingdao Municipal Hospital（Group）,the identification of bacteria and drug sensitivity test were carried out by VITEK-2Compact automatic microbiology system.Confirmatory test of extended spectrumβ-lactamases（ESBLs）were conducted by the double disk diffusion method.Results：A total of 1 252 strains of pathogens were isolated,57.8%from the department of respiration,15.3% from ICU and 13.5%from neurology.Gram-negative bacilli accounted for 62.5%（783/1 252）,Gram-positive cocci were 33.4%（418/1 252）,and fungi 4.1%（51/1 252）.The prevalence of ESBLs producing strains were 56.4%and 38.7%in E.coli and K.pneumoniae respectively,the drug resistance rate of Gram-negative bacilli to penicillin and cephalosporin were higher,but sensitive to imipenem,the drug resistance rate of ESBLs producing strains were significantly higher than that of non-ESBLs producing strains.S.aureus remained highly sensitive to vancomycin and teicoplanin,but showed high resistance to other antibiotics.Conclusion：The Gram-negative bacilli were the major pathogenic bacteria causing lower respiratory tract infections,and it shows multi-drug resistance,clinician should pay more attention to the drug resistance.
出处
《医学理论与实践》
2015年第10期1279-1281,共3页
The Journal of Medical Theory and Practice
关键词
下呼吸道感染
病原菌
耐药性
Lower respiratory tract infection, Pathogens, Drug resistance
