咽喉炎患者局部病原菌分布特点与耐药性分析  

Analysis on the local distributing pattern of pathogenic bacteria and their characteristics of drug resistance among patients with sphagitis

作　　者：严景辉[1] 韦文[1] 王豪[1] YANJinghui;WEIWen;WANGHao(Department of Otorhinolaryngology-Head & Neck Surgery, the Third Huizhou Municipal People’s Hospital, Guangdong, 516001, China)

机构地区：[1]广东省惠州市第三人民医院耳鼻咽喉头颈外科,516001

出　　处：《中国中西医结合耳鼻咽喉科杂志》2018年第6期444-447,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨咽喉炎患者局部病灶病原菌的种类分布及其耐药性特点,为临床治疗提供实验依据。方法 2015年8月～2016年8月于我院就诊的80例咽喉炎患者,采集咽喉分泌物标本行细菌培养及药敏试验,分析患者咽喉部病原菌种类分布与耐药性特点。结果本组病例共检出病原菌100株,其中革兰阳性菌19株(19.00%),包括3株粪肠球菌、3株表皮葡萄球菌、4株肺炎链球菌以及8株金黄色葡萄球菌;革兰阴性菌81株(81.00%),主要为鲍氏不动杆菌、株铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌;革兰阴性菌菌株数显著高于革兰阳性菌(P<0.05)。革兰阳性菌耐药率较低的抗菌药物为头孢唑肟和万古霉素,耐药率较高并超过80%的有左氧氟沙星、头孢唑林、氟氯西林以及甲氧苄啶;革兰阴性菌耐药率较低的药物为庆大霉素,耐药率较高的有头孢曲松、头孢唑林、美罗培南。结论咽喉炎患者感染的主要致病菌类型为革兰阴性菌,对常用抗菌药物的耐药性明显,临症之际,应根据患者感染情况合理选用抗菌药物。Objective To investigate the local distributing patterns of pathogenic bacteria in the upper respiratory track and their characteristics of drug resistance among patients with sphagitis based on a clinical trial so as to provide experimental basis for treatment of this kind of conditions.Methods Included in this study were 80 cases of patients with sphagitis treated in our hospital since Aug.,2015 to Aug.,2016.All patients were taken secretion samples from their throat for bacteria culturing and pathogen separating at first,and then,drug resistance was conducted via chemosensitivity test,followed by an analysis on the distributing patterns of pathogen species and their characteristics of drug resistance.Results The total number of separated pathogen species was 100,among which 19 strains were gram-positive(19.00%),including 3 strains of enterococcus faecalis,3 strains of stagphylococcus epidermidis,4strains of streptococcus pneumoniae,8strains of staphylococcus aureus and1strains of other bacterial,and81strains were gram-negative(81.00%),mainly being 12 strains of acinetobacter baumannii,13strains of pseudomonas aeruginosa,16strains of escherichia coli and 29 strains of klebsiella pneunoniae and11strains of other bacterial,with the strain numbers of gram-negative bacteria significantly higher than that of gram-positive bacteria(P<0.05).The antibiotics with lower rates of drug resistance to gram-positive bacteria included ceftizoxime and vancomycin,and those with higher rates of drug resistance more than80%to this kind of bacteria were levofloxacin,cefazolin,flucloxacillin and trimethoprim.However,the drug with lower rate of resistance to gram-negative bacteria was gentamicin,and those with relatively higher rates of drug resistance to this kind of bacteria were ceftriaxone,cefazolin and meropenem respectively.Conclusions The commonly seen pathogenic bacterial strains among patients with sphagitis are gram-negative bacteria with much higher rates of drug resistance to common antibiotics.Therefore,the selection of

关 键 词：咽喉炎 病原菌分布特点 耐药性 抗生素选择 

分 类 号：R446.5[医药卫生—诊断学] R766.5[医药卫生—临床医学]