成人下呼吸道感染病原菌群的分布与耐药性研究  

Study on the distribution and drug resistance of bacteria in hospitalized adults with lower respiratory tract infection

作　　者：杜方兵 吕志[1] 杨万春[1] DU Fang-bing;LV Zhi;YANG Wan-chun　(Department of Respiratory Medicine,the Second People’s Hospital of Hefei,Hefei,Anhui　230011,China)

机构地区：[1]合肥市第二人民医院呼吸内科,安徽合肥230011

出　　处：《临床肺科杂志》2018年第5期840-843,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的分析我院下呼吸道感染住院成年患者呼吸道标本中的耐药菌分布及耐药特点。方法选择我院2014年1月至2017年1月所收治的300例下呼吸道感染患者,对其下呼吸道标本中的细菌进行分离培养,并对其耐药性进行分析。结果 300例标本中共分离培养出183株细菌,其中革兰阴性杆菌120株(65.6%),主要为大肠埃希氏菌、肺炎克雷伯菌、铜绿假单胞菌和鲍氏不动杆菌;革兰阳性球菌63株(34.4%),主要为肺炎链球菌、金黄色葡萄球菌、溶血性链球菌和肠球菌。耐药结果显示,大肠埃希氏菌、肺炎克雷伯菌、铜绿假单胞菌对β-内酰胺类药物耐药明显,而对含酶抑制剂的抗生素及碳青霉素类抗生素较为敏感;鲍氏不动杆菌仅对碳青霉素类抗生素和头孢哌酮舒巴坦有一定活性;肺炎链球菌、金黄色葡萄球菌、溶血性链球菌和肠球菌耐药明显,但对万古霉素和替考拉宁仍较敏感,头孢吡肟也保持一定抗菌活性。结论下呼吸道感染住院患者的呼吸道感染细菌以革兰阴性杆菌为主,细菌耐药较严重,应结合患者耐药检测结果进行合理的用药。Objective To study the distribution and drug resistance of bacteria in hospitalized patients with lower respiratory tract infection.Methods From January 2014 to January 2017,300 hospitalized patients with lower respiratory tract infection were included.The bacteria from lower respiratory tract were isolated and antibiotic resistance was analyzed.Results 183 strains were isolated from 300 patients.120 strains were gram negative bacilli(65.6%),mainly including E.coli,K.pneumonia,P.aeruginosa and A.baumannii.63 strains were gram positive coccus(34.4%),mainly including S.pneumonia,S.aureus,H.streptococcus and faecalis.E.coli,K.pneumonia and P.aeruginosa had the highest resistance toβ-lactam antibiotics,but sensitive toβ-lactamase inhibitor compounds.A.baumannii was only susceptible to carbapenems and sefperazone-sulbactam.The antibiotic resistance of Gram-positive bacilli were serious,but teicoplanin,vancomycin and cefepime were still effective.Conclusion Gram-negative bacilli occupies a dominant position in the bacteria from patients with lower respiratory tract infection,and the antibiotic resistance is serious.

关 键 词：下呼吸道感染 细菌耐药 合理用药 

分 类 号：R446.5[医药卫生—诊断学] R56[医药卫生—临床医学]