山东省医院感染监控网下呼吸道感染病原菌分布及耐药性分析  

Lower Respiratory Tract Infection from Shandong Provincial Nosocomial Infection Surveillance System: A Study on Pathogen and Drug Resistance

作　　者：王一兵[1] 李卫光[1] 朱其凤[1] 

机构地区：[1]山东省立医院,山东济南250021

出　　处：《中华医院感染学杂志》2005年第5期490-492,共3页Chinese Journal of Nosocomiology

摘　　要：目的　了解下呼吸道感染病原菌谱及耐药性。方法　统计分析山东省医院感染监控网,2002 年和2003 年下呼吸道感染病原菌及耐药情况。结果　在8 808例医院获得性肺炎患者中,分离出病原菌1 954株,占22.18%,其中以革兰阴性杆菌为主,占71.39%,铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌和阴沟肠杆菌分列前5位;革兰阳性球菌占15.81%,金黄色葡萄球菌、表皮葡萄球菌和肠球菌属分列前3位;真菌占12.80%,以白色念珠菌为主;药敏结果提示亚胺培南对革兰阴性杆菌作用最强,革兰阳性球菌对万古霉素高度敏感,对其他抗菌药物存在不同程度的耐药。结论　近年来医院获得性肺炎病原菌以革兰阴性杆菌为主,并出现多重耐药,应根据药敏选择抗菌药物。OBJECTIVE To acquaint pathogen distribution of lower respiratory tract infection and drug resistance. METHODS Summaries and analysis of data from Shandong provincial nosocomial infection surveillance system were conducted from 2002 to 2003. RESULTS Totally 1 954 strains of pathogenic bacteria were found in sputum samplesfrom 8 808 patients with hospital acquired pneumonia. Among them, Gram-negative pathogens occupied 71.39%,Gram-positive were 15.81%, and fungi were 12.80%. The 5 common Gram-negative pathogens were Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii and Enterobacter. Staphylococcus aureus, S. epidermidis and Enterococcus were 3 main pathogens in Gram-positives and Candida albicans was the most common in fungi. Gram-negative bacteria were the first sensitive to imipenem. And Gram-positive bacteria were the first sensitive to vancomycin. CONCLUSIONS Gram-negative pathogens are the dominant in hospital acquired pneumonia. The emergence of multi-drug resistance is a serious problem in Gram-negative pathogens, and the drug sensitivity test results are significant in proper selection of antibiotics.

关 键 词：下呼吸道感染 病原菌 耐药性 

分 类 号：R563.1[医药卫生—呼吸系统]