1268份痰培养结果及药敏分析  

Pathogenic Bacteria and Their Antibiotic Susceptibility of 1 268 Sputum Specimens

作　　者：黄甦[1] 王敏莲[2] 涂建成[3] 

机构地区：[1]武汉大学医院内科,湖北武汉430072 [2]武汉大学人民医院,湖北武汉430060 [3]武汉大学中南医院检验科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2009年第6期830-833,共4页Medical Journal of Wuhan University

摘　　要：目的:分析不同年龄组下呼吸道感染的细菌和真菌病原学分布及耐药状况,为临床合理使用抗生素提供依据。方法:回顾性分析2006年1月至2008年12月本院内科和儿科送检的痰标本培养及药敏结果,并根据年龄不同分为小儿组(6个月-13岁)、成人组(14-64岁)和老年组(65岁及以上)。结果:痰培养阳性率为39.8%,其中革兰阴性杆菌感染占62.3%(316/507),革兰阳性球菌占33.7%(171/507),真菌感染和混合感染分别占0.98%(5/507)和2.96%(15/507)。成人组和老年组中肺炎克雷伯杆菌和铜绿假单孢菌的比例明显高于小儿组(P<0.05);而小儿组的肺炎链球菌的比例显著高于成人组和老年组(P<0.05);老年组中真菌和混合性感染的几率较高。对常见革兰阴性杆菌敏感性最高的抗生素是亚胺培南,其次为头孢噻肟和头孢他啶。但几乎所有细菌均对氨苄青霉素耐药。常见革兰阳性球菌均对万古霉素100%敏感,其次为利福平。对青霉素和苯唑青霉素的耐药性均较高。结论:不同年龄的下呼吸道感染患者,其细菌病原学构成显示不同的特点,而且总体耐药现象严重,应该严格执行用药前进行病原学检测和药物敏感试验,以指导下呼吸道感染的合理用药。Objective：To study the antibiotic susceptibility patterns of pathogenic bacteria in patients with lower respiratory tract infection （LRTI）. Methods：Sputum specimens for bacterial culture were collected in sterile tubes from the patients with LRTI between Jan,2006 and Dec,2008. The subjects were divided into three groups according to different age：children group （6 months to 13 years old）,adults group （14 to 64 years old）,and senior group （ 〉or =65 years old）. Methods：A ratio of 39.8% patients were positively infected,of which Gram-negative bacteria accounted for 62.3%,gram-positive bacteria for 33.7%,fungi for 0.98%,and mixed infection for 2.96%. Klebsiella pneumoniae and P. aeruginosa were the more common bacteria in adults and seniors than in children,while streptococcus pneumoniae was more common in children. Imipenem showed the best activity against most Gram-negative bacteria,followed by cefotaxime and ceftazidime. The most susceptible antibiotic for Gram-positive bacteria was vancomycin,followed by rifampin. Almost all Gram-negative bacteria showed resistant to ampicillin and most of Gram-positive bacteria were resistant to penicillin and oxacillin. Conclusion：Gram-negative bacteria are the most common pathogenic organisms in LRTI in this study. But the proportion of pathogenic agents is different among different age groups. The antibiotics resistance is severe. So bacterial culture of sputum should be examined before initiating antibiotics treatment for LRTI.

关 键 词：下呼吸道 感染 病原学 细菌 耐药 

分 类 号：R563.1[医药卫生—呼吸系统]