下呼吸道感染病原体分布及药敏结果分析  

Distribution and drug resistance of pathogenic bacteria analysis causing the lower respiratory tract infection

作　　者：张文娟[1] 钟鸣[1] 谭平[1] 

机构地区：[1]吉林大学中日联谊医院呼吸内科,吉林长春130033

出　　处：《中国实验诊断学》2015年第12期2056-2059,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的了解我院呼吸科下呼吸道感染常见病原体分布及细菌耐药情况,以便更好地指导临床抗生素的应用。方法对2013年1月至2014年12月我院呼吸科诊断为下呼吸感染的住院患者所送检的痰液、肺泡灌洗液、胸腔积液液、血液等细菌培养及药敏结果进行回顾性统计分析。结果共送检3783份标本,共检出566株病原菌。其中革兰阴性菌占63.4%,革兰阳性菌占8.0%,真菌占28.6%。革兰阴性菌对碳青霉烯类、头胞哌酮舒巴坦、哌拉西林他唑巴坦、阿米卡星、替加环素有较好的敏感性,对一、二、三代头孢菌素、半合成青霉素耐药性较高。革兰阳性菌对大部分药物耐药率超过50%,未发现对替加环素、万古霉素、利奈唑胺耐药的菌株。结论下呼吸道感染病原菌中以革兰阴性菌居多,不同的菌株对不同的抗生素耐药性不同,临床医师应及时了解当地病原菌分布及耐药情况,以指导临床经验性用药。Objective To investigate the distribution and antimicrobial resistance of pathogens from the patients who were diagnosed as lower respiratory tract infections of the respiratory department in our hospital,in order to provide better guidance for the clinical application of antibiotics.Methods Analyzed the culture results and drug sensitivity of sputum,alveolar lavage fluid,pleural effusion and blood,which collected from the patients who were diagnosed as lower respiratory tract infections of the respiratory department in our hospital during Jan 2013 to Dec 2014.Results Totally3783 samples were tested and 566 strains of pathogens were isolated,including gram-negative bacteria,accounting for63.4%,gram-positive bacteria with the share rate of 8.0%,and fungi,accounting for 28.6%.The gram-negative bacteria were sensitive to carbapenems,cefoperazone sulbactam,piperacillin-tazobactam,amikacin and tigecycline,while gram-negative bacteria had high drug resistance to the first,second and third generation cephalosporins and semi-synthetic penicillin.The drug resistance rates of gram-positive bacteria to most drugs were more than 50%.The tigecycline-,vancomycin-or linezolid-resistant pathogens strains have not been detected.Conclusion Infection caused by Gram-negative bacteria is predominant in the pathogens causing lower respiratory tract infections,varying in drug resistance.the physician should understand local pathogenic bacteria distribution and drug resistance timely,in order to guide the clinical empirical use of drugs.

关 键 词：下呼吸道感染 病原菌 耐药性 抗生素 

分 类 号：R446.5[医药卫生—诊断学]