下呼吸道感染细菌分布及耐药率分析  

Distribution of lower respiratory tracts infection and analysis of antibiotic resistrant rate.

作　　者：潘玫[1] 陈山[2] 李稳[1] 

机构地区：[1]山东中医药大学附属医院,济南250012 [2]山东省立医院,济南250021

出　　处：《医学检验与临床》2006年第3期27-28,50,共3页Medical Laboratory Science and Clinics

摘　　要：目的探讨近年下呼吸道感染病原菌的细菌分布及耐药情况,为临床医生合理用药提供帮助.方法利用SENSITITREAris系统对我院2004年1月～2005年12月间收治的下呼吸道感染患者标本中分离的致病菌进行鉴定和药敏试验.结果458株病原菌中,革兰氏阴性杆菌377株(82.30%),革兰氏阳性球菌81株(17.70%).革兰氏阴性杆菌对氨苄青霉素耐药率最高,几乎达100%,亚胺培南的耐药率从0～18.5%.美罗培南耐药率低于亚胺培南,大肠埃希菌和肺炎克雷伯菌超广谱β-内酰胺酶阳性率分别为32.6%和41%,MRSA占所分离金黄色葡萄球菌的90%.结论革兰阴性菌是院内下呼吸道感染的主要病原菌,多重耐药菌占有相当的比例,抗生素的选用应该依据感染菌药敏结果的分析.Objective Study the Pathogens distribution and analysis the antibiotic resistrant rate in lower respiratory tracts infection,so that to help clinical therapy.Method Bacterial strains from lower respiratory tracts infection in our hospital were collected between Jan.2004 and Dec.Organism identification and antimicrobial susceptibility testing were performed using the SENSITITRE Aris system.Result There are 377(82.3%) gram-negative and 81(17.70%) gram-positive bacterial strains in all 458 strains.Ampiicillin has the highest resistance rate,nearly 100%,in contrast,the imipenem resistance has the lower resistance rate from 0～18.5%.Meropenem resistance rate is lower than imipenem.Production of extended-spectrum-?-lactamases(ESBLs) in Escherichia coli and Klebsiella pneumoniae are 32.6% and 41%.methicillin-resistant Staphylococcus aureus(MRSA) is about 90%.Conclusion Gram negitive bacteria is major pathogens in lower respiratory tracts infection,we should make a prescription according to the result of antimicrobial susceptibility test.

关 键 词：院内下呼吸道感染 细菌分布 耐药率 革兰氏阴性杆菌 感染病原菌 亚胺培南 金黄色葡萄球菌 革兰氏阳性球菌 肺炎克雷伯菌 革兰阴性菌 多重耐药菌 大肠埃希菌 氨苄青霉素 药敏试验 药敏结果 内酰胺酶 美罗培南 临床医生 合理用药 超广谱β 

分 类 号：R446.5[医药卫生—诊断学]