2009-2011年医院下呼吸道感染患者病原菌分布及耐药性分析  

Distribution and drug resistance of pathogenic bacteria causing lower respiratory tract infections from 2009 to 2011

作　　者：黄东红[1] 谢若腾[1] 章宏斌[1] 蔡晶晶[1] 

机构地区：[1]福建医科大学附属第二医院检验科,福建泉州362000

出　　处：《中华医院感染学杂志》2013年第17期4296-4297,4302,共3页Chinese Journal of Nosocomiology

基　　金：福建医科大学附属第二医院苗圃基金课题(2012)

摘　　要：目的了解下呼吸道感染的病原菌分布及耐药性,为临床合理应用抗菌药物提供依据。方法 2009年1月-2011年12月以纤维支气管镜防污染毛刷采集刷检物,采用法国生物梅里埃公司提供的VITEK-2Compact微生物分析仪进行细菌鉴定及药敏试验。结果检出病原菌125株,其中革兰阴性杆菌占95.2%、革兰阳性球菌占4.8%;病原菌主要来源于呼吸科、ICU、免疫血液科、神经外科;分布前3位的病原菌为铜绿假单胞菌、鲍氏不动杆菌、嗜麦芽寡养单胞菌,分别占29.6%、18.4%、12.0%;病原菌对抗菌药物的耐药性较严重,铜绿假单胞菌对阿米卡星、哌啦西林/他唑巴坦、头孢他啶、亚胺培南的耐药率分别为13.5%、16.2%、18.9、16.2%;鲍氏不动杆菌除对米诺环素和头孢哌酮/舒巴坦耐药率分别为17.4%和21.7%外,对其他抗菌药物的耐药率均>50.0%;产ESBLs肺炎克雷伯菌阳性率为42.9%。结论下呼吸道感染的主要病原菌为革兰阴性杆菌,细菌对多种抗菌药物耐药现象严重,临床应合理使用抗菌药物。OBJECTIVE To explore the distribution and the drug resistance of pathogenic bacteria causing lower re-spiratory tract infections from protected specimen brush in order to provide evidence for clinical reasonable use ofantibiotics. METHODS The specimens were collected from the fiberoptic bronchoscopes with the use of pollutionprevention brush from Jan 2009 to Dec 2011. The identification and drug susceptibility testing for the bacteria wereperformed using VITEK 2 COMPACT microbial analyzer from France. RESULTS A total of 125 pathogenic bacteria were identified,gramnegative bacilli accounted for 95. 2% , and grampositive cocci accounted for 4. 8%. Thepathogens were mainly isolated from the department of respiratory,ICU, immuneblood and neurosrugery department. Pseudomonas aeruginosa was the most frequently isolated bacteria, followed by Acinetobacter baumannii,Stenotrophomonas pseudoalcaligen.es , Klebsiella pneumonia e and Chromobacterium meningosepticum. The drugresistance rates of P. aeruginosa strains to amikacin, ceftazidime piperaccllin-tazobactam, and imipenem were13. 5% ,16. 2% , 18. 9%,and 16. 2% ,respectively. The drug resistance rates of A. baumannii strains to all the an-tibiotics tested were above 50. 0% except minocycline（17. 4%） and sulbactam-cefoperazone（21. 7%）. The positiverates of extended-spectrum （3-lactamase （ESBLs ）-producing K. pneumoniae was 42. 9 %. CONCLUSION Thegram-negative bacilli are the main pathogens causing the lower respiratory tract infections and are highly multi-drug-resistant, and the antibiotics should be used reasonably.

关 键 词：防污染毛刷 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]