呼吸科病房病原菌分布及耐药性研究  

Research on distribution and drug resistance of pathogens in respiratory ward

作　　者：朱景倩[1] 赵建平[1] 涂军伟[1] 盛琳[1] 陈慧君[1] 

机构地区：[1]金华市中心医院呼吸科,浙江金华321000

出　　处：《中华医院感染学杂志》2013年第8期1943-1945,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析医院2011年呼吸科病房下呼吸道感染患者病原菌分布特点及其耐药性,为临床科学用药提供依据。方法对下呼吸道感染住院患者送检的痰标本中分离出病原菌,用全自动细菌鉴定及药敏测定仪进行耐药性监测。结果 2822例下呼吸道感染住院患者中,共分离出革兰阴性菌326株占74.8%;革兰阳性菌110株占25.2%;检出率排前5位的病原菌依次为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍氏不动杆菌、金黄色葡萄球菌;肺炎克雷伯菌及大肠埃希菌中产ESBLs株分别占38.6%和58.4%,产ESBLs株对多种抗菌药物的耐药率均显著高于非产酶株;铜绿假单胞菌对阿米卡星、妥布霉素、哌拉西林、环丙沙星及亚胺培南的敏感率>70.0%,鲍氏不动杆菌对临床常用抗菌药物耐药率较高,未检出耐万古霉素、利奈唑胺金黄色葡萄球菌。结论对该地区病原菌进行监测,掌握常见病原菌分布及耐药特点,对合理选择抗菌药物非常重要。OBJECTIVE To analyze the distribution and drug resistance of the pathogens causing lower respiratory tract infections in the respiratory ward in 2011 so as to provide basis for scientific use of antibiotics.METHODS The pathogens were isolated from clinical sputum specimens of the hospitalized patients who were diagnosed as lower respiratory tract infections,the surveillance of drug resistance was performed by using automatic bacterial identification system and drug susceptibility testing system.RESULTS The survey included 2822 patients with lower respiratory tract infections in the hospital.There were 326（74.8%） strains of gram-negative bacilli and 110（25.2%） strains of gram-positive cocci detected.The species of bacteria whose detection rates ranked top five were Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa,Acinetobacter baumanii,and Staphylococcus aureus.The detection rates of ESBLs-producing K.pneumoniae and E.coli strains were 38.6% and 58.4%,respectively.The ESBLs-producing strains had a stronger resistance to most antibiotics than did the non-ESBLs-producing strains.The drug susceptibility rates of P.aeruginosa to amikacin,tobramycin,piperacillin,ciprofloxacin,and imipenem were above 70.0%.A.baumannii strains were highly drug resistant to commonly used antibioticsa,and no strains were found resistant to vancomycin or linezolid.CONCLUSION It is very important to observe the drug resistance of local pathogens and to master the characteristics of bacterial resistance and distribution so that a reasonable use of antimicrobials is guaranteed.

关 键 词：呼吸科 病原菌 耐药率 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]