呼吸科下呼吸道感染者病原菌分布及耐药性分析  

The pathogen distribution and drug resistance of respiratory tract infection in the department of respiration

作　　者：张玉华[1] 吕方方[1] 杨秋平[1] 

机构地区：[1]武警后勤学院附属医院呼吸与重症医学科,天津市300162

出　　处：《中华实验和临床感染病杂志（电子版）》2015年第6期104-106,共3页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：武警后勤学院附属医院科研基金(No.FYM201109)

摘　　要：目的探讨本院呼吸内科收治的下呼吸道感染者的病原菌分布及耐药性分析,为本院使用抗菌药物提供依据。方法收集2013年10月至2014年10月本院呼吸内科病房218例下呼吸道感染者的痰培养结果,进行细菌鉴定和药敏监测。结果218例感染者共分离出327株病原菌,主要为革兰阴性菌,占65.7%,排在前5位的病原菌分别是铜绿假单胞菌(27.7%)、肺炎克雷伯菌(14.3%)、金黄色葡萄球菌(11.6%)、大肠埃希菌(9.4%)和屎肠球菌(7.9%)。主要病原菌对抗菌药物普遍耐药,其中革兰阴性菌对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南较为敏感,革兰阳性菌对利奈唑胺、万古霉素、替考拉宁、磺胺甲噁唑/甲氧苄啶较敏感。结论呼吸内科下呼吸道感染的病原菌以革兰阴性菌为主,主要病原菌对常用抗菌药物的耐药形势较为严峻,临床上应合理选用抗菌药。Objective To investigate the characteristics and the pathogen distribution of drug resistance in patients with lower respiratory tract infection,and to provide evidence for clinical rational use of antimicrobial agents.Methods The culture results of sputum collected from 218 patients with lower respiratory tract infection,October 2013 to October 2014 in the Respiratory Department of Internal Medicine Ward in our hospital were collected.The bacteria identification and drug sensitivity monitoring were detected.Results Total of 327 strains of pathogenic bacteria were isolated from 218 cases with infection,mainly Gram negative bacteria,accounting for 65.7%,ranked in the top five pathogenic bacteria were Pseudomonas aeruginosa（27.7%）,Klebsiella pneumoniae（14.3%）,Staphylococcus aureus（11.6%）,Escherichia coli（9.4%）,Enterococcus faecium（7.9%）.The main pathogenic bacteria were generally resistant to antibiotics,the Gram negative bacteria were more sensitive to piperacillin/tazobactam,imipenem,cefoperazone/shubatan,while Gram positive bacteria were sensitive to vancomycin,linezolid,teicoplanin,sulfamethoxazole/trimethoprim.Conclusions The pathogenic bacteria of internal medicine lower respiratory tract infection in respiratory department were mainly Gram negative bacteria,and drug resistance of main pathogenic bacteria is more severe,so clinical attention should be paid to the rational use of antimicrobial agents.

关 键 词：呼吸科 下呼吸道感染 病原菌分布 耐药性 

分 类 号：R446.5[医药卫生—诊断学]