呼吸内科痰标本的病原菌谱及耐药性分析  

Analysis on spectrum and drug resistance of pathogens from sputum specimens of respiratory medicine department

作　　者：陈丽霞[1] 苏育林 

机构地区：[1]泉州医学高等专科学校基础医学部,福建泉州362011 [2]泉州医学高等专科学校附属人民医院检验科,福建泉州362000

出　　处：《临床肺科杂志》2016年第3期478-480,484,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的分析呼吸内科患者痰标本的病原菌分布及耐药性情况，为临床医师合理使用抗菌药物提供科学依据。方法收集呼吸内科患者痰标本855份，分离鉴定病原菌并进行药物敏感试验。结果检出病原菌271株，检出率为31．70％。检出革兰阴性杆菌最多，占53．63％，其中居前三位的是肺炎克雷伯菌、铜绿假单胞菌和大肠埃希菌。大肠埃希菌呈多重耐药，耐药情况比肺炎克雷伯菌、铜绿假单胞菌严重（χ^2=358．808，P=0．000），对青霉素类、磺胺类、头孢菌素类和喹诺酮类等药物的耐药率为64．71％-100％；肺炎克雷伯菌对替卡西林、哌拉西林的耐药率高，分别为91．30％和86．96％；铜绿假单胞菌对复方新诺明的耐药率100％。3种革兰阴性杆菌对碳青酶烯类未产生耐药性。结论革兰阴性杆菌是呼吸内科患者痰标本中的主要病原菌，真菌其次。革兰阴性杆菌对抗菌药物的耐药性存在差异，临床医师应该合理使用抗生素，以达到减少耐药菌株的产生和控制疾病的目的。Objective To analyze spectrum and drug resistance of pathogens from sputum specimens of respiratory medicine department. Methods 855 sputum specimens were collected in the department of respiratory medicine, and the pathogenic bacteria were separated and identified to give drug sensitive test. Results 271 strains of pathogen were detected from the submission of sputum specimens and the separation was 31.70%. Gram-negative bacilli took up 53. 63%, mainly including Klebsiella pneumoniae, Pseudomonas aeruginosa and E. eoli. E. coli was multi-drug resistant, which was more serious than the rest two （ χ^2 = 358. 808, P = 0. 000）. The resistance to penicillin, sulfa, cephalosporins and quinolones was from 64.71% to 100%. The resistance of KPN to tiearcillin and piperacillin was 91.30% and 86. 96% respectively. The resistance of PAE to cotrimoxazole was 100%. The three kinds of gram-negative bacillus did not develop resistance to carbapenems. Conclusion The major pathogens are Gram-negative bacilli in sputum culture, and their drug resistance is different. The antibiotics should be rational used in order to reduce drug-resistant strains of the disease.

关 键 词：呼吸内科 痰标本 病原菌 抗菌药物 耐药性 

分 类 号：R446.5[医药卫生—诊断学]