某医院下呼吸道感染住院患者痰培养细菌分布和药敏情况分析  

Bacterial distribution and drug sensitivity of sputum culture of inpatients with lower respiratory tract infection in a hospital

作　　者：尹青霞 Yin Qingxia(Clinical Laboratory,Henglan Hospital of Zhongshan City,Zhongshan 528478,Guangdong,China)

机构地区：[1]中山市横栏医院检验科,广东中山528478

出　　处：《实用检验医师杂志》2021年第1期7-9,共3页Chinese Journal of Clinical Pathologist

摘　　要：目的观察并分析一个市级医院下呼吸道感染住院患者痰培养细菌分布和药敏情况。方法选择2018年3月—2019年3月中山市横栏医院收治的210例下呼吸道感染住院患者作为研究对象,所有患者均进行痰培养细菌鉴定和药敏分析,观察病原菌种类及病原菌在各科室的分布情况,分析革兰阴性(G^(-))菌和革兰阳性(G^(+))菌的耐药情况。结果210例下呼吸道感染住院患者中共检出215株病原菌,在不同科室中病原菌检出数量最多的为重症监护病房(ICU;67株,占31.16%),其次为内科(30株,占13.95%)、儿科(25株,占11.63%)、外科(23株,占10.70%)。共检出G^(-)杆菌142株(占66.05%),其中主要为肺炎克雷伯菌〔20.93%(45/215)〕、大肠埃希菌〔15.35%(33/215)〕、铜绿假单胞菌〔14.42%(31/215)〕;共检出G^(+)球菌73株(占33.95%),其中主要为金黄色葡萄球菌〔10.70%(23/215)〕、粪肠球菌〔9.30%(20/215)〕、肺炎链球菌〔8.37%(18/215)〕。在G^(-)菌中,肺炎克雷伯菌、大肠埃希菌和铜绿假单胞菌对氧氟沙星和甲硝唑的耐药率较高,但对庆大霉素和阿米卡星的耐药率较低;在G^(+)菌中,金黄色葡萄球菌、粪肠球菌和肺炎链球菌对头孢唑啉和红霉素的耐药率较高,对青霉素的耐药率较低。结论中山市横栏医院下呼吸道感染住院患者痰培养病原菌主要为G^(-)菌,对不同抗菌药物的耐药性不同,临床应根据药敏试验结果,合理使用抗菌药物对患者进行治疗以减少临床耐药菌株产生。Objective To observe and analyze the bacterial distribution and drug sensitivity in sputum culture of inpatients with lower respiratory infection.Methods 215 inpatients with lower respiratory infection admitted in Henglan Hospital of Zhongshan City from March 2018 to March 2019 were selected as research objects.The bacterial identification and drug sensitivity analysis of sputum culture were carried out in all patients.The distribution of pathogenic bacteria,distribution of pathogenic bacteria in all departments and drug resistance of Gram negative(G^(-))and Gram positive(G^(+))bacteria were observed.Results A total of 215 strains of pathogens were detected among 210 hospitalized patients with lower respiratory tract infection,the pathogens were found most commonly in intensive care unit(ICU;67 strains,31.16%),followed by department of internal medicine(30 strains,13.95%),department of pediatrics(25 strains,11.63%)and department of surgery(23 strains,10.70%).A total of 142 strains(66.05%)of G^(-)bacilli were detected,mainly Klebsiella pneumoniae[20.93%(45/215)],Escherichia coli[15.35%(33/215)]and Pseudomonas aeruginosa[14.42%(31/215)];73 strains(33.95%)of G^(+)cocci were detected,mainly Staphylococcus aureus[10.70%(23/215)],Enterococcus faecalis[9.30%(20/215)]and Streptococcus pneumoniae[8.37%(18/215)].In G^(-)bacteria,Klebsiella pneumoniae,Escherichia coli and Pseudomonas aeruginosa had higher resistance to Ofloxacin and Metronidazole but lower resistance to Gentamicin and Amikacin;in G^(+)bacteria,Staphylococcus aureus,Enterococcus faecalis and Streptococcus pneumoniae had higher resistance to Cefazolin and Erythromycin but lower resistance to Penicillin.Conclusions G^(-)bacteria are the main pathogens of lower respiratory tract infection in Henglan Hospital of Zhongshan City,and their drug resistant rates to different antibiotics are different.According to the results of drug sensitivity,antibiotics should be used reasonably to reduce the clinical drug-resistant strains.

关 键 词：痰培养 下呼吸道感染 细菌分布 药敏情况 

分 类 号：R446.5[医药卫生—诊断学]