2012-2015年厦门地区下呼吸道标本分离细菌的分布和药物敏感性分析  

Distribution and antimicrobial susceptibility of the microorganisms isolated from lower respiratory tract in Xiamen during 2012-2015

作　　者：蔡雪莹[1] 曾惠清[1] 张孝斌[1] 黄茂宏[1] 姚艺辉 连炯斌[3] 陈桂山 

机构地区：[1]厦门大学附属中山医院,福建医科大学教学医院呼吸科,福建厦门361004 [2]厦门市临床检验中心细菌室 [3]厦门市中医院呼吸科 [4]厦门市第五医院呼吸科

出　　处：《中国感染与化疗杂志》2016年第6期774-778,共5页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解厦门地区3所综合性医院下呼吸道标本分离细菌的分布及对抗菌药物敏感性,为临床用药提供指导。方法收集2012—2015年来自厦门地区3所综合性医院患者下呼吸道标本分离的細菌,按美国国家临床实验室标准化协会(CLSI)标准进行药物敏感性试验。结果共分离出细菌4 981株细菌,其中革兰阳性菌1 568株,占31.5%,革兰阴性菌3 413株,占68.5%。耐甲氧西林菌株中金黄色葡萄球菌和凝固酶阴性葡萄球菌分別占各自菌种的75.0%(342/456)和72.6%(294/405),未发现耐万古霉素的菌株。肺炎克雷伯菌和大肠埃希菌中ESBL的检出率分别为39.3%(316/805)和42.9%(210/489),产ESBL菌株对大多数抗菌药物的耐药率明显高于非产ESBL菌株。鲍曼不动杆菌对碳青霉烯类药物的耐药率达50.0%以上。铜绿假单胞菌对头孢吡肟、氨基糖苷类、多黏菌素B等药物敏感率较高。结论厦门地区综合性医院下呼吸道标本分离的细菌以革兰阴性菌为主,其对目前常用的多种抗菌药物耐药率呈上升趋势。Objective To investigate the distribution and antimicrobial susceptibility of the bacterial strains isolated from lower respiratory tract in 3 general hospitals of Xiamen for improving antibiotic use.Methods Pathogens isolated from lower respiratory tract during 2012-2015 were analyzed.Antimicrobial susceptibility testing was performed according to CLSI document.Results Of the 4 981 clinical isolates,gram-positive bacteria and gram-negative bacteria accounted for 31.5%（1 568/4 981） and 68.5%（3 413/4 981）,respectively.The prevalence of methicillin-resistant strains is 75.0%（342/456） in Staphylococcus aureus strains and72.6%（294/405） in coagulase negative Staphylococcus.No vancomycin-resistant staphylococcal strains were identified.ESBLs were produced in 39.3%（316/805） of Klebsiella isolates and 42.9%（210/489） of if.coli isolates,respectively.The ESBLs-producing strains were significantly more resistant to most of the antibiotics than the corresponding non-ESBLs-producing strains.More than 50.0% of the Acinetobacter baumannii strains were resistant to carbapenems.Pseudomonas aeruginosa strains were relatively suscepuoie to cereprme,ammogiycosiues and porymyxm B.Conclusions Gram-negative bacilli are the main pathogens in lower respiratory tract infections in Xiamen.Antibiotic resistance is increasing in the gram-negative strains isolated from lower respiratory tract.

关 键 词：下呼吸道感染 细菌 药敏试验 

分 类 号：R446.5[医药卫生—诊断学] R56[医药卫生—临床医学]