下呼吸道分离菌11106株的分布及耐药性分析  

Distribution and drug resistance of 11 106 pathogens isolated from lower respiratory tract

作　　者：郭小兵[1] 田富云[1] 贺小红[1] 胡晓欣[1] 任益慧 饶玉婷[1] 刘娜[1] 

机构地区：[1]郑州大学第一附属医院检验科,郑州450052

出　　处：《郑州大学学报（医学版）》2017年第6期728-732,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：河南省科技发展计划项目162102310509

摘　　要：目的:了解下呼吸道分离菌的分布及耐药特征,为临床合理用药提供指导和依据。方法:对郑州大学第一附属医院2016年1月至12月下呼吸道标本分离的非重复菌株进行回顾性分析,按CLSI 2015年版标准判读药敏结果。结果:下呼吸道标本共分离出11 106株细菌,革兰阴性菌占77.7%,革兰阳性菌占6.5%,真菌占15.8%。常见分离菌依次为鲍曼不动杆菌(26.4%)、肺炎克雷伯菌(22.1%)、铜绿假单胞菌(16.6%)、金黄色葡萄球菌(5.8%)和大肠埃希菌(3.2%)。药敏结果显示,肠杆菌科细菌对碳青霉烯类最敏感,肺炎克雷伯菌和大肠埃希菌产ESBL菌株检出率分别为50.0%和62.1%,产ESBL菌株对抗菌药物的耐药率均高于非产ESBL菌株。鲍曼不动杆菌耐药现象最严重。铜绿假单胞菌对氨基糖苷类敏感性最高。MRSA检出率为58.6%。呼吸科多重耐药株检出率最高,其次为ICU。结论:医院下呼吸道分离菌耐药现象严重。临床医师应重视病原学检查并根据药敏结果合理选择抗菌药物。Aim： To investigate the distribution and drug resistance of bacteria isolated from lower respiratory tract,so as to provide guidance and basis for clinical rational use of drugs. Methods： The nonduplicate strains isolated from lower respiratory tract in the First Affiliated Hospital of Zhengzhou University from January to December 2016 were retrospectively analyzed. The results of bacteria medicine sensitive test were analyzed according to CLSI 2015. Results： A total of 11 106 strains were isolated from lower respiratory tract specimens,out of which gram-negative bacteria accounted for 77. 7%,gram-positive bacteria accounted for 6.5%,and fungi for 15.8%.The most common strains were Acinetobacter baumannii（26.4%）,Klebsiella pneumoniae（22.1%）,Pseudomonas aeruginosa（16.6%）,Staphylococcus aureus（5.8%）,and Escherichia coli（3.2%）.Most enterobacteriaceae bacteria were sensitive to carbapenems.The prevalence of ESBL-producing in Klebsiella pneumoniae and Escherichia coli was 50.0% and 62.1%,respectively.The drug resistance rates of ESBL producing strains were all higher than non-ESBL producing strains.Acinetobacter baumannii was the most serious drug resistance strain.Aminoglycosides were the most active antibiotic against Pseudomonas aeruginosa.The prevalence of MRSA in Staphylococcus aureus was 58.6%.Multi-drug resistant strains were highest in respiratory ward,followed by ICU.Conclusion：The phenomenon of antibiotic resistance is serious.It is required that clinical should rational use of antibiotics according to the results of antimicrobial susceptibility testing.

关 键 词：呼吸道感染 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]