荔城医院反复下呼吸道感染住院患者的临床感染状况分析  

Clinical Conditions of Repeated Lower Respiratory Infection in Licheng Hospital

作　　者：列敏冬 

机构地区：[1]广州市增城区荔城医院,广东广州511300

出　　处：《中国医学创新》2016年第27期56-59,共4页Medical Innovation of China

基　　金：2015年度广东省医学科研基金立项管理项目(A2015306)

摘　　要：目的:分析荔城医院反复下呼吸道感染住院患者的临床感染状况,为临床治疗用药提供实验室诊断依据。方法:选择荔城医院2014年7月-2015年5月反复下呼吸道感染住院患者200例菌痰标本,回顾性分析患者的痰培养资料及药敏试验资料。结果:反复下呼吸道感染住院患者200例菌痰标本中,阳性90例,阳性率为45.0%;在90例阳性菌痰标本中,病原菌为100株,包括革兰阴性菌57株(57.0%)、革兰阳性菌30株(30.0%)、真菌13株(13.0%);革兰阴性菌中,肺炎克雷伯杆菌、大肠埃希菌及铜绿假单胞菌最多;革兰阳性菌中,溶血性葡萄球菌及金黄色葡萄球菌最多;真菌以白色假丝酵母菌为主;混合感染以革兰阴性菌合并真菌感染为主。革兰阴性菌药敏试验中,氨苄西林、头孢唑啉耐药率最高,分别为87.7%、84.2%,其次为左氧氟沙星,耐药率为61.4%;亚胺培南耐药率最低,为10.5%;57株革兰阴性菌中,ESBLs阳性菌株20株,阳性率35.1%;革兰阳性菌药敏试验中,青霉素耐药率最高,为90.0%;其次是头孢呋辛,耐药率为66.7%;利奈唑胺及万古霉素耐药率最低,分别为0、6.7%。在10株金黄色葡萄球菌中,检出MRSA菌株4株,阳性率40.0%。结论:荔城医院反复下呼吸道感染的住院患者中,其病原菌大部分为较易产生耐药及引发院内感染的特殊细菌,以革兰阴性菌居多,对常用抗生素耐药严重,对少用的新一代抗生素仍有一定的敏感性,临床需注意合理用药,避免耐药性进一步加重。Objective： To analyze the clinical conditions of repeated lower respiratory infection in Licheng Hospital and provide laboratory diagnosis basis for clinical treatment.Method： The sputum samples for 200 cases of repeated lower respiratory infection treated in Licheng Hospital from July 2014 to May 2015 were selected, the data of patients with drug sensitibility test and sputum culture were retrospectively analyzed.Result： In 200 cases of hospitalized patients, bacteria in sputum specimens was 90 cases, the positive rate was 45.0%, in 90 cases of positive sputum specimens, the pathogenic bacteria of 100 strains, including 57 strains （ 57.0% ） of gram-negative bacteria, 30 strains （ 30.0% ） of gram positive bacteria and 13 strains （ 13.0% ） of fungus.For the gram-negative bacterium, the klebsiella pneumoniae, escherichia coli and pseudomonas aeruginosa was dominated; for the gram-positive bacterium, the staphylococcus haemolyticusand staphylococcus aureus was dominated; for fungus, the candida albicans was dominated; for the mixed infection, the gram-negative bacterium and fungal infection was dominated.Through the drug sensitive test of gram-negative bacterium, the drug resistance rate of Ampicillin and Cefazolin was 87.7% and 84.2%, the drug resistance rate of Levofloxacin was 61.4%, the drug resistance rate of lmipenem was 10.5%.For 57 strains of gram-negative bacterium, there were 20 strains （ 35.1% ） of positive ESBLs. Through the drug sensitive test of gram-positive bacterium, the drug resistance rate of Penicillin was 90.0%.Then the drug resistance rate of Cefuroxime was 66.7%, the drug resistance rate of Linezolid and Vancomycin was 0 and 6.7%.For 10 strains of staphylococcus aureus, there were 4 strains of MRSA and the positive rate was 40.0%. Conclusion： In Licheng Hospital, repeated lower respiratory tract infection in hospitalized patients, most of the pathogen resistance more easily and special bacteria causing nosocomial infection, with the majority of gramnegative bacteria, dr

关 键 词：荔城医院 革兰阴性菌 革兰阳性菌 药敏试验 下呼吸道感染 

分 类 号：R56[医药卫生—呼吸系统]