呼吸内科住院患者下呼吸道感染病原菌分布及耐药情况分析  

Pathogenic bacteria distribution and drug resistance situation of hospitalized patients in respiratory medicine with lower respiratory tract infection

作　　者：邢艳利[1] 谭智[1] 李鸣[1] 林建聪[1] 张常然[1] 

机构地区：[1]中山大学附属第一医院东院普通内科,广东广州510700

出　　处：《现代预防医学》2016年第5期951-953,共3页Modern Preventive Medicine

摘　　要：目的了解2014年我院呼吸内科下呼吸道感染住院患者痰标本病原菌分布情况及耐药特征。方法收集2014年1~12月,我院呼吸内科住院部收治的下呼吸道感染患者1008例进行痰液标本检验,分析标本中病原菌的构成情况及主要几种致病菌对常用抗菌药的耐药率。结果 1008名患者送检标本共分离得到病原菌468份,检出率为46.4%。其中,分离出革兰阴性菌307株（65.60%）,革兰阳性菌127株（27.14%）,真菌34株（7.26%）。在分离的革兰阴性菌中,所占构成比最高为铜绿假单胞菌（97株,20.73%）,其次为肺炎克雷伯菌72株（15.38%）;革兰阳性菌中所占比例最大的为肺炎链球菌57株（12.18%）,其次为金黄色葡萄球菌31株（6.62%）;真菌共检出34株（7.26%）,白假丝酵母菌在真菌中所占比例最大（3.48%）。结论下呼吸道感染的住院患者中,革兰阴性菌感染所占比例较高,铜绿假单胞菌是革兰阴性菌中的主要致病菌。致病菌的耐药率较高,对各类药物的耐药率不尽相同,临床应根据药敏实验结果合理使用抗菌药。Objective To understand the distribution and drug resistance of pathogenic bacteria of sputum specimens in hospitalized patients with lower respiratory tract infection in our department of respiratory medicine during 2014. Methods Sputum specimens of 1008 patients with lower respiratory tract infection admitted in the department of respiratory medicine from Jan. to Dec. 2014 were collected,and the composition of pathogenic bacteria and the drug resistance rate of main pathogenic bacteria in the specimens were analyzed. Results 468 samples of the pathogenic bacteria were isolated from 1008 patients,and the detection rate was 46. 4%. Among the strains of pathogens,the gram- negative bacteria（ 307 strains） accounted for65. 60%,the gram- positive bacteria（ 127 strains） accounted for 27. 14%,and the fungi（ 34 strains） accounted for 7. 26%. In the isolated gram- negative bacteria,the highest proportion of the total was Pseudomonas aeruginosin（ 97 strains,20. 73%）,followed by pneumonia klebsiella bacteria 72 strains（ 15. 38%）. Correspondingly,in the isolated gram- positive bacteria,the highest proportion of the total was streptococcus pneumonia（ 57 strains,12. 18%）,which was followed by Staphylococcus aureus（ 31 strains,6. 62%）. Candida albicans was the main component of fungus（ 3. 48%）. Conclusion Among the hospitalized patients with lower respiratory tract infection in the department of respiratory medicine,the gram-negative bacteria infection rate is higher. Pseudomonas aeruginosin is the main one of pathogenic bacteria in the gram- negative bacteria strains. The drug resistance rate of pathogenic bacteria was higher,and the drug resistance rate was not the same. According to the susceptibility experiment,the rational use of antimicrobial,on the one hand,can increase the therapeutic effect,on the other hand,can also prevent bacterial drug resistance.

关 键 词：呼吸内科 下呼吸道感染 病原谱 耐药性 

分 类 号：R117[医药卫生—公共卫生与预防医学]