摘要
目的分析下呼吸道感染患者病原菌分布及耐药性,指导临床合理用药。方法收集我院2013年至2015年院内感染患者痰标本进行细菌培养和药物敏感性试验。结果 3年共收集下呼吸道痰液标本21 615份,分离病原菌5 621株,阳性率为26.0%;其中革兰阴性(G^-)菌4 249株,占75.6%,以铜绿假单胞菌居多(20.7%);真菌764株,占13.6%,以白假丝酵母居多(12.6%);革兰阳性(G^+)菌608株,占10.8%,以金黄色葡萄球菌居多(9.9%)。药物敏感试验结果显示:G^-杆菌对亚胺培南、美洛培南耐药率最低,对青霉素类、喹诺酮类和部分三代头孢类等抗菌药耐药率较高(>50.0%)。G^+球菌对万古霉素、利奈唑胺耐药率为零,对青霉素类、喹诺酮类和红霉素等抗菌药耐药率较高(>40.0%)。结论下呼吸道感染患者病原菌以G^-杆菌为主,耐药性呈增长趋势,临床应加大病原菌分布检测及其耐药性监测力度,及时调整抗菌药物用药。
Objective To analyze the distribution and drug resistance of the pathogens causing lower respiratory tract infections,and provide basis for reasonable use of antibiotics.Methods The pathogens isolated from the sputum specimens of patients with lower respiratory tract infections from 2013 to 2015were cultured and their drug sensitivities were determined.Results 5,621 strains of pathogens were isolated from21,615 sputum specimens;the isolation rate was 26.0%.Among them,there were 4,249（75.6%）strains of Gram-negative bacteria,with Pseudomonas aeruginosa（20.7%）being predominant;764（13.6%）strains were fungi,with Candida albicans（12.6%）being predominant;608（10.8%）strains were Gram-positive bacteria,with Staphylococcus aureus（9.9%）being predominant.The resistance rates of Gram negative bacilli to imipenem and meropenem were the lowest,while those to penicillins,quinolones and some third generation cephalosporins were high（〉50.0%）.None of the Gram positive cocci were resistant to vancomycin and teicoplanin,but they were highly resistant to penicillins,quinolones and erythromycin etc（〉40.0%）.Conclusion Gram negative bacilli remain the commonest pathogens causing lower respiratory tract infections,which are highly resistant to the commonly used antibiotics.The distribution and drug resistance of the pathogenic bacteria should be monitored continuously to guide clinical use of antibacterial drugs.
出处
《中国微生态学杂志》
CAS
CSCD
2017年第5期563-566,共4页
Chinese Journal of Microecology
关键词
下呼吸道感染
细菌培养
耐药性
Lower respiratory tract infections
Bacterial culture
Drug resistance
