医院内下呼吸道感染病原菌谱及耐药性研究  

Bacterial spectrum and drug resistance of pathogens causing nosocomial lower respiratory tract infections

作　　者：曹卓[1] 潘炯伟[1] 

机构地区：[1]丽水市人民医院呼吸内科,浙江丽水323000

出　　处：《中华医院感染学杂志》2013年第1期213-215,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨医院下呼吸道感染病原菌谱及耐药性,为指导临床应用抗菌药物提供参考。方法采集医院2010年1月-2012年1月下呼吸道感染住院患者的痰标本,将合格痰标本接种至血平板、麦康凯平板培养24～48h,然后按照《全国临床检测操作规程》,采用法国生物梅里埃公司API鉴定试条进行细菌鉴定,采用纸片扩散法(K-B)进行药敏试验,依据2002年版美国临床实验室标准化委员会药敏试验纸片扩散法标准进行操作和判断结果。结果从1034份合格痰标本中分离出873株病原菌,检出率为84.4%,革兰阴性杆菌517株占59.22%,真菌215株占24.63%,革兰阳性菌141株占16.15%;革兰阴性菌对亚胺培南的耐药性最低,其次是阿米卡星,均<45.00%;革兰阳性菌对万古霉素高度敏感,达到100.00%。结论下呼吸道感染主要病原菌为革兰阴性杆菌,其次为真菌和革兰阳性菌,细菌耐药性日益严重,应根据药敏结果合理选择抗菌药物。OBJECTIVE To explore the bacterial spectrum and drug resistance of the pathogens causing lower respiratory tract infections so as to provide reference for the clinical use of antibiotics. METHODS The sputum specimens were collected from the hospitalized patients with lower respiratory tract infections from Jan 2010 to Jan 2012. The eligible sputum specimens were inoculated to the blood agar plate and the MacConkey tablet for the bacterial culture for 24- 48 hours. According to the National Clinical Laboratory Operation Standards, the bacteria were isolated and identified with API identification strips of Bio-Merieux, France. The drug susceptibility testing was performed by using the K-B method, the results were iudged by referring to the standards for the operation of K-B fordrug susceptibility testing by the NCCLS, 2002 edition. RESULTS A total of 873 strains of pathogens were isolated from 1034 eligible sputum specimens with the detection rate of 84. 40%, including 517 （59.22%） strains of gram-negative bacteria, 215 （24.63%） strains of fungi,and 141 （16.15%） strains of gram-positive bacteria. The results of antimicrobial sensitivity testings showed that the drug resistance rate of the gram-negative bacteria was the lowest to imipenem, followed by amikacin. The gram-positive bacteria were highly sensitive to vancomycin, reaching up to 100. 00%. CONCLUSION The gram-negative bacilli are the main pathogens causing the lower respiratory tract infections, followed by fungi and gram-positive bacteria. The bacterial resistance becomes increasingly serious, thus it is necessary to reasonably use antibiotics on the basis of drug susceptibility testing result.

关 键 词：下呼吸道感染 病原菌 耐药性 药敏试验 

分 类 号：R378[医药卫生—病原生物学]