支气管肺泡灌洗液312份细菌定量培养及药物敏感性分析  

bacteria quantitative cultivation and antibiotic susceptibility analysis for 312 samples of bronchoalveolar lavage fluid

作　　者：孙淑红[1] 胡晓峰[1] 朱德全[1] 

机构地区：[1]山东省临沂市人民医院临床检验中心,276003

出　　处：《中华临床感染病杂志》2012年第2期69-72,共4页Chinese Journal of Clinical Infectious Diseases

摘　　要：目的 分析支气管肺泡灌洗液(balf)细菌定量培养中病原菌的分布及其对常用抗菌药物的敏感情况.方法 将312份balf样本用10μl取菌环分别划线接种于巧克力平板、血平板及麦康凯平板进行定量培养,细菌菌落数大于104 cfu/ml为致病菌,用vitek 2-compact全自动微生物分析系统鉴定菌株,并用k-b法、etest法和稀释法进行药敏试验.结果 312份balf样本共分离出病原菌216株,检出率为69.2％.革兰阴性杆菌以铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌和大肠埃希菌为主,革兰阳性球菌以金黄色葡萄球菌、肺炎链球菌及表皮葡萄球菌为主.药敏试验结果显示,铜绿假单胞菌对氨曲南等耐药率较高,对哌拉西林/他唑巴坦、亚胺培南、头孢吡肟、左氧氟沙星、头孢他啶和阿米卡星的耐药率均在30％以下；金黄色葡萄球菌对红霉素、青霉素及克林霉素的敏感情况较差,而对呋喃妥因、万古霉素、喹奴普汀/达福普汀、替加环素和利奈唑烷均完全敏感.结论 balf培养阳性率较高,常见致病菌为铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌、金黄色葡萄球菌和大肠埃希菌等,各病原菌对常用抗菌药物的耐药情况严重.objective to investigate the distribution and antibiotic susceptibilities of quantitatively cultivated bacteria from bronchoalveolar lavage fluid (balf) samples. methods totally 312 balf samples were streak inoculated to chocolate,blood and mac plates with 10 μl annulus,and the bacterial colony ＞ 104 cfu/ml was considered pathogenic bacteria. the identification of pathogenic bacteria was carried out with vitek 2-compact,and kirby-bauer disc agar diffusion method,etest and dilution method were used for antibiotics sensitivity test.results totally 216 (69.2％) strains of pathogenic bacteria were isolated.the major gram-negative strains were pseudomonas aeruginosa,acinetobacter baumannii,klebsiella pneumoniae and escherichia coli, and the major gram-positive strains were staphylococcus aureus,streptococcus pneumoniae and staphylococcus epidermidis.the resistance rate of pseudomonas aeruginosa to aztreonam was high,but lower than 30％ to piperacillin/tazobactam,imipenem,cefepime,ofloxacin,ceftazidime and amikacin.staphylococcus aureus was highly resistant to erythromycin,benzylpenicillin and clindamycin,but it was sensitive to furadantin,vancomycin,quinupristin/dalfoprisdn,tigecycline and linezolid.conclusion the positive rate of balf cultivation is high,and the main pathogenic bacteria pseudomonas aeruginosa, acinetobacter baumannii, klebsiella pneumoniae, staphylococcus aureus and escherichia coli are resistant to several commonly used antibiotics.

关 键 词：支气管肺泡灌洗液 微生物敏感性试验 定量培养 

分 类 号：R446.5[医药卫生—诊断学]