下呼吸道感染主要革兰阴性菌分布与耐药性分析  

Distribution and drug resistance of main gram-negative bacteria causing lower respiratory tract infections

作　　者：陈红梅[1] 周永良[1] 刘俊[1] 

机构地区：[1]浙江省磐安县人民医院感染科,浙江磐安县322300

出　　处：《中华医院感染学杂志》2015年第2期311-312,326,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅基金资助项目(2012KYA155)

摘　　要：目的探讨医院下呼吸道感染主要革兰阴性菌的分布及其耐药性,为下呼吸道感染患者的治疗提供用药借鉴。方法选取2011年1月-2013年12月住院治疗的下呼吸道感染患者82例,采集所有患者合格痰标本,采用VITEK-2Compact全自动微生物分析系统对病原菌进行鉴定及药敏试验,使用WHONET5.4软件进行统计分析。结果 82例呼吸道感染患者痰液标本中共分离出革兰阴性菌105株,前4位依次为肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、鲍氏不动杆菌,分别占20.00%、19.05%、17.14%、17.14%;肺炎克雷伯菌与大肠埃希菌对头孢唑林、头孢他啶、氨曲南、呋喃妥因的耐药率均<30.00%;对亚胺培南耐药率均<6.00%;肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌对氨苄西林、头孢替坦耐药率较高,均>80.00%。结论医院患者下呼吸道感染的主要革兰阴性菌以肺炎克雷伯菌、铜绿假单胞菌等为主,药敏差异较大,临床应根据药敏结果针对性选择用药,减少耐药菌株出现。OBJECTIVE To explore the distribution and drug resistance of the main gram-negative bacteria causing lower respiratory tract infections so as to provide guidance for treatment of lower respiratory tract infections.METHODS A total of 82 patients with lower respiratory tract infections who were hospitalized for treatment from Jan 2011 to Dec 2013 were enrolled in the study,the eligible sputum specimens were collected from all the patients,the pathogens were identified by using VITEK-2Compact automatic microorganism analysis system,the drug susceptibility testing was conducted,and the statistical analysis was performed by using WHONET5.4software.RESULTS Totally 105 strains of gram-negative bacteria have been isolated from the sputum specimens obtained from the 82 cases of respiratory tract infections;the Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,and Acinetobacter baumannii ranked the top four places,accounting for 20.00%,19.05%,17.14%,and 17.14%,respectively.The drug resistance rates of the K.pneumoniae and E.coli to cefazolin,ceftazidime,aztreonam,and nitrofurantoin were less than 30.00%,and the drug resistance rates to imipenem were less than 6.00%;the K.pneumoniae,P.aeruginosa,and E.coli were highly resistant to ampicillin and cefotetan,with the drug resistance rates more than 80.00%.CONCLUSION The K.pneumoniae and P.aeruginosa are the predominant species of gram-negative bacteria causing the lower respiratory tract infections and vary significantly in the drug susceptibility.It is necessary for the hospital to reasonably use antibiotics on the basis of results of the drug susceptibility testing so as to reduce the drug-resistant strains.

关 键 词：下呼吸道感染 革兰阴性菌 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]