呼吸科病房患者病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens in wards of respiratory medicine department

作　　者：邵鹏群[1] 李永胜[2] 杨秀云[3] 孟芹芹 

机构地区：[1]河南科技大学第二附属医院药剂科,河南洛阳471000 [2]上海应用技术学院材料科学与工程学院,上海201418 [3]河南科技大学第二附属医院检验科,河南洛阳471000

出　　处：《中华医院感染学杂志》2014年第14期3402-3404,共3页Chinese Journal of Nosocomiology

基　　金：上海市科技促进会联盟计划基金资助项目(LM201124)

摘　　要：目的分析医院2012年呼吸科病房下呼吸道感染患者病原菌分布特点及耐药性,为临床抗感染提供病原学依据。方法于2012年1-12月对呼吸科下呼吸道感染患者送检的痰液及支气管冲洗液标本2 236份中分离出病原菌483株,用全自动细菌鉴定及药敏测定仪进行耐药性鉴定。结果 2 236份标本中共检出病原菌483株,检出率21.6%,检出率由高到低依次为铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌、嗜麦芽寡养单胞菌、肺炎链球菌等,前5种病原菌占77.9%;大肠埃希菌及肺炎克雷伯菌中产ESBLs的菌株检出率分别为58.2%和25.0%;鲍氏不动杆菌对头孢哌酮/舒巴坦、多黏菌素B、头孢吡肟、头孢他啶耐药率<40.0%;嗜麦芽寡养假单胞菌对左氧氟沙星、磺胺甲噁唑/甲氧苄啶、替卡西林/克拉维酸耐药率<40.0%。结论医院呼吸内科检出病原菌以革兰阴性菌为主且耐药现象严重,建议临床合理应用抗菌药物,以延缓病原菌耐药性发生。OBJECTIVE To analyze the distribution and drug resistance of pathogens causing lower respiratory tract infections in patients of wards of respiratory medicine department so as to provide etiological basis for clinical treatment of infections.METHODS From Jan to Dec,2012,totally 483strains of pathogens were isolated from 2236submitted sputum and bronchoalveolar lavage fluid specimens obtained from the patients with lower respiratory tract infections,then the automatic bacterial identification and the drug susceptibility testing were performed.RESULTS A total of 483strains of pathogens have been isolated from the 2 236specimens with the detection rate of 21.6%;the pathogens,with the isolation rates from high to low,were as follows：Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii,Stenotrophomonas maltophilia,Streptococcus pneumoniae;the top five species of pathogens accounted for 77.9%.The isolation rate of the ESBLs-producing E.coli was 58.2%,the ESBLs-producing K.pneumoniae 25.0%.The drug resistance rates of the A.baumannii to cefoperazone/sulbactam,polymyxin B,cefepime,and ceftazidime were less than 40.0%;the drug resistance rates of the S.maltophilia to levofloxacin,sulfamethoxazole-trimethoprim,and ticarcillin clavulanic acid were less than 40.0%.CONCLUSIONS The gram-negative bacteria are the predominant pathogens isolated from the department of respiratory medicine and are highly resistant to antibiotics.It is suggested that the antibiotics should be reasonably used so as to delay the drug resistance of the pathogens.

关 键 词：呼吸内科 病原菌 耐药率 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]