下呼吸道感染病原菌耐药性变化趋势  

Change of drug resistance of pathogens causing lower respiratory tract infections

作　　者：王苒[1] 李敏 周思静[3] 孙耕耘[1] 朱钟鸣[1] 胡先纬[1] 李永怀[1] 

机构地区：[1]安徽医科大学第一附属医院呼吸内科 [2]肿瘤科,安徽合肥230001 [3]合肥市第三人民医院职业病科,安徽合肥230001

出　　处：《中华医院感染学杂志》2014年第17期4194-4196,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81300041);安徽省高校自然科学基金资助项目(KJ2012Z184);安徽医科大学中青年学术骨干基金资助项目(2013)

摘　　要：目的了解医院2009—2011年下呼吸道感染的病原菌分布及耐药性变迁，为临床使用抗菌药物和医院抗菌药物管理提供依据。方法调查分析医院2009—2011年的住院患者的痰培养结果和耐药性，所有数据使用WHONET5．4软件进行分析。结果共分离出病原菌6219株，其中革兰阴性菌占72．4％，革兰阳性菌占15．9％，真菌占11．7％；革兰阴性菌对二、三代头孢菌素的耐药率逐年升高，大肠埃希菌对二、三代头孢菌素的耐药率为11．4％～65．7％，肺炎克雷伯菌对二、三代头孢菌素的耐药率为41．0％～67．0％；不动杆菌属和铜绿假单胞菌对碳青霉烯类药物的耐药率明显升高，不动杆菌属对亚胺培南的耐药率最高59．6％，铜绿假单胞菌对亚胺培南的耐药率也由2009年的23．5％升至2011年的27．7％；2011年革兰阳性菌对青霉索、头孢类抗菌药物、左氧氟沙星和红霉素的耐药率均＞30．0％，未发现耐万古霉素和替考拉宁的金黄色葡萄球菌。结论下呼吸道感染病原菌的耐药率逐年升高，医院应该加强对某些抗菌药物使用的管理。OBJECTIVE To understand the distribution and drug resistance of pathogens causing lower respiratory tract infections in 2009-2011 so as to provide guidance for clinical use of antibiotics and management of antibiotics. METHODS From 2009 through 2011, the result of sputum culture for the hospitalized patients and the drug resistance were analyzed, and all the data were analyzed with the use of WHONET 5.4 software. RESULTS A total of 6219 strains of pathogens have been isolated, among which the gram-negative bacteria accounted for 72.4%, the gram-positive bacteria 15.90%the fungi 11.7%. The drug resistance rates of the gram-negative bacteria to the second and third generation of cephalosporins increased year by year; the drug resistance rates of the Escherichia coli to the second and third generation of cephalosporins varied from 11.4%to 65.7%; the drug resistance rates of the Klebsiella pneumoniae to the second and third generation of cephalosporins varied from 41.0%to 67.0%; the drug resistance rates of the Acinetobacter spp and Pseudomonas aeruginosa to carbapenems were significantly increased, and the drug resistance rate of the Acinetobacter spp to imipenem was the highest （59.6 %） ; the drug resistance rate of the P. aeruginosa to imipenem increased from 23.5% in 2009 to 27.7% in 2011; the drug resistance rates of the gram-positive bacteria to penicillin, cephalosporins, levofloxacin, and erythromycin were more than 30.0%; the vaneomycinor teicoplanin-resistant Staphylococcus aureus strains have not been detected.

关 键 词：下呼吸道感染 病原菌 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]