1200例次院内下呼吸道感染的病原菌及其药敏试验分析  

Investigation on bacteria of inpatients with lower respiratory infection:analysis of sputum culture and drug sensitivity

作　　者：于文成[1] 吕秀文[1] 翟振国[1] 李德宸[1] 刘蓬蓬[1] 李慧[1] 张少燕[1] 

机构地区：[1]青岛医学院附属医院

出　　处：《中国危重病急救医学》1998年第12期744-746,共3页Chinese Critical Care Medicine

摘　　要：目的：调查住院患者下呼吸道感染细菌菌群变迁及药敏试验情况，以指导临床应用抗生素。方法：对住院下呼吸道感染患者清晨多次漱口后咳深部痰或气管插管、气管切开患者用无菌吸痰管从气管内吸痰，于无菌管中进行培养并做药敏试验。结果：１２００例次下呼吸道感染痰培养共培养出细菌１３７８株，其中阴性杆菌与阳性球菌分别为８０．１９％和１９．８１％。其中不动杆菌感染率明显上升，居第２位（占１９．０１％）；药敏试验结果表明细菌耐药性明显增加。头孢三代、丁胺卡那霉素等抗生素为大多数细菌敏感，喹诺酮类抗生素在药敏试验中显示了很好的抗菌活性。结论：下呼吸道感染的致病菌以阴性杆菌为主，不动杆菌所占比例明显升高，今后可能成为下呼吸道感染首位致病菌；细菌耐药性明显增强，医生应严格控制抗生素的应用以降低细菌耐药性；Objective:To observe changes in bacterial strains of inpatients with lower respiratory tract infection and drug sensitivity in order to guide the clinical use of antibiotics.Methods:After gargle several times in the morning,sputum samples from lower respiratory tract were collected into disinfected tubes,then cultures and drug sensitivity were performed with those samples.Results:In 1 200 cases,1 378 strains were obtained from lower respiratory tract sputum samples,80 19% of which were gram negative bacilli and 19 81% were grampositive cocci.Among 1 378 strains,19 01% were Acinetobacter,and Acinetobacter infection was obviously increasing,ranking the second predominant bacteria in inpatients with lower respiratory infection.Drug sensitivity showed that resistant bacteria were markedly increasing,but most bacteria were sensitive to the third generation Cephalosporin and Amikacin,and Quinolones had high antibiotic effectiveness.Conclusions:The gramnegative bacilli are the major pathogens in inpatients with lower respiratory infection.The incidence of Acinetobacter infection is increasing and Acinetobacter would be ranked as the first predominant pathogen in future.In addition,the resistant bacteria are increasing.These data suggest that controlled use of antibiotics can reduce bacterial infection and drug resistance,Quinolone may become the antibiotic of first choice in the treatment of lower respiratory infection.

关 键 词：下呼吸道感染 痰培养 药敏试验 治疗 

分 类 号：R563.105[医药卫生—呼吸系统]