下呼吸道感染病原菌分布及耐药性分析  

Pathogenic Bacteria in Lower Respiratory Tract Infection:Their Distribution and Drug Resistance Analysis

作　　者：黄文智 李淑英[2] 

机构地区：[1]宜春市人民医院预防保健科,江西宜春336000 [2]宜春学院医学院卫生系,江西宜春336000

出　　处：《中华医院感染学杂志》2008年第9期1328-1330,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解下呼吸道感染病原菌的分布及耐药现状,帮助临床合理使用抗菌药物。方法按《全国临床检验操作规程》或API鉴定系统及K-B法,对1326份痰标本进行病原菌分离、鉴定和药敏试验。结果1326份合格痰标本分离出病原菌982株,检出率74.1%,其中革兰阴性杆菌540株,占55.0%,革兰阳性球菌196株,占20.0%,真菌246株,占25.0%;1326份合格痰标本中检出存在混合感染的标本176份,占13.3%;革兰阴性杆菌对亚胺培南耐药性最低,其次是头孢哌酮和阿米卡星,对氨苄西林耐药率最高,234株克雷伯菌属中ESBLs阳性菌89株,占38.0%;50株大肠埃希菌中ESBLs阳性菌20株,占40.0%,金黄色葡萄球菌和表皮葡萄球菌对青霉素耐药率分别高达97.5%和97.2%,对万古霉素均敏感,其次对环丙沙星较敏感;90株金黄色葡萄球菌检出MRSA57株,占63.3%,75株表皮葡萄球菌检出MRSE42株,占56.0%。结论在下呼吸道感染中,革兰阴性杆菌是主要的病原菌,但真菌引起的感染高于革兰阳性球菌引起的感染,混合菌感染占了一定的比例,应引起临床高度重视。OBJECTIVE To investigate the distribution and resistance of pathogens in lower-respiratory tract infection in our area, and help doctors to use antibiotic reasonably. METHODS According to National Guide to Clinical Laboratory Procedures, API identification system or K-B method, the pathogens of 1326 cases sputum specimens were isolated, identified and tested in drug sensitive test. RESULTS A total of 982 strains of pathogens that included 540 （20.0%） G- bacilli, 196 （20.0%） G＋ cocci and 246 （25.1%） fungi were isolated from 1326 sputum specimens and the detection rate was 74. 1%. From them 176 cases which occupied 13.3% were with mixed infection. The drug resistance of G- bacilli to imipenem was the lowest, then was to cefoperazone and amikacin, but the resistance of ampicillin was the highest. From 234 strains of Klebsiella had 89 strains of ESBLs- positive; in 50 strains of Escherichia coli, the strains of ESBLs-positive were 20 （40.0%）. The resistance rate of Staphylococcus aureus and S. epidermidis to penicillin was 97.5 % and 97.2 %, respectively, both of them were sensitive to vancomycin, and less sensitive to ciprofloxacin. Fifty seven strains of MRSA were detected from 90 strains of S. aureus （63.3%）; and 42 strains of MRSE were detected （56.0%）. CONCLUSIONS G- bacilli are the main pathogens in lower respiratory tract infection and the infection caused by fungi is more than that caused by G＋ cocci, so we must pay attention also to mixed infection which occupies certain ratio.

关 键 词：感染病原菌 分布 耐药性 

分 类 号：R378.11[医药卫生—病原生物学]