下呼吸道分离病原菌种类及药敏分析  

Analysis of species and drug sensitivity of pathogenic bacteria isolated from lower respiratory tract

作　　者：孙荷[1] 茅国锋[1] SUN He;MAO Guo-feng(Clinical Laboratory Center,Shaoxing People's Hospital(Shaoxing Hospital of Zhefiang University)Shaoxing ,Zhejiang 312000,China)

机构地区：[1]绍兴市人民医院(浙江大学绍兴医院)临床检验中心,浙江绍兴312000

出　　处：《中国卫生检验杂志》2019年第2期171-173,182,共4页Chinese Journal of Health Laboratory Technology

基　　金：浙江省医药卫生一般研究计划B类(2016KYB304)

摘　　要：目的了解绍兴市人民医院住院患者下呼吸道标本分离出的常见病原菌种类及耐药情况,为临床合理用药提供依据。方法回顾性分析绍兴市人民医院2016年12月-2017年12月送检的住院患者下呼吸道标本分离出的病原菌及药敏试验结果。结果共分离出5 282株病原菌,主要为革兰阴性菌,共3 680株,占69. 7%;其次为真菌,共1 488株,占28. 2%;革兰阳性球菌114株,占2. 2%。药敏结果显示,肺炎克雷伯菌对多数抗生素敏感,ESBL阳性率为16. 2%。大肠杆菌对奎诺酮类抗生素耐药率较高,ESBL阳性率为62. 9%;铜绿假单胞菌对碳青霉烯类抗生素和头孢他啶耐药率高,对丁胺卡那和哌拉西林/他唑巴坦敏感,而鲍曼不动杆菌对除丁胺卡那外的其他抗生素的耐药率均较高。结论革兰阴性杆菌为下呼吸道标本分离出的主要病原菌,临床应结合患者体征及相关炎症指标,根据药敏试验结果正确选择抗菌药物。Objective To understand the common pathogenic bacteria distribution and its drug resistance which separated from lower respiratory tract of the in-patients in Shaoxing People’s Hospital and provide basis for guide clinical therapy. Methods The specie s and drug resistance of the pathogenic bacteria separated from our hospital’ s in-patients from December 2016 to December2017 was analyzed retrospectively. Results 5 282 pathogenic bacterial strains were separated from lower respiratory tract,and were Gram-negative bacteria mostly,3 680 cases,accounting for 69. 7%. Next were fungus,1 488 cases,accounting for28. 2%. The rest were Gram-positive bacteria,which were 114 strains,accounting for 2. 2%. According to the drug sensitive test,Klebsiella pneumonia was sensitive to most antibiotics and the positive ratio of ESBL was 16. 2% to ESBL,but Escherichia coli had a high drug resistance ratio to Quinolones antibiotics and the positive ratio of ESBL was 62. 9%. Pseudomonas aeruginosa had a high drug resistant to carbopenems and ceftazidime antibiotic,and were sensitive to Amikacin and piperacillin/tazobactam antibiotics,and Bauman Acinetobacter were high resistant to other antibiotics except Amikacin. Conclusion Gram-negative bacillus was the main pathogens isolated from lower respiratory tract. The infection rate of Fungi is also high. We should pay more attention to the category of pathogenic bacteria in clinic and select the proper antibiotic according to drug sensitivity test to prevent the increase of drug resistance.

关 键 词：下呼吸道 病原菌 耐药率 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]