下呼吸道感染120例痰标本细菌培养及耐药分析  

Bacterial Culture and Drug Resistance Analysis of Sputum Specimens from 120 Cases with Lower Respiratory Tract Infection

作　　者：黄玉兰 Huang Yu-lan(Chengdu Angel Women's and Children's Hospital,Chengdu 610041,Sichuan Province,China)

机构地区：[1]成都安琪儿妇产医院,四川成都610041

出　　处：《中国社区医师》2022年第22期61-63,共3页Chinese Community Doctors

摘　　要：目的:分析120例下呼吸道感染患者痰标本细菌培养及耐药情况。方法:选取2020年9月-2021年9月成都安琪儿妇产医院收治的下呼吸道感染患者120例,挑选脓性部分痰液进行涂片,经过革兰染色后镜检并进行细菌培养、菌株鉴定以及药敏试验。结果:120例患者中检出革兰阴性杆菌72株,其中鲍曼不动杆菌复合菌24株,肺炎克雷伯菌肺炎亚种17株,铜绿假单胞菌24株,阴沟肠杆菌复合菌5株,大肠埃希菌(ESBL+)2株,革兰阴性杆菌检出率为60.0%;检出革兰阳性菌8株,革兰阳性菌检出率为6.7%,其中金黄色葡萄球菌4株,表皮葡萄球菌2株,肺炎球菌2株;检出真菌40株,真菌检出率为33.3%,白色假丝酵母菌26株,克柔假丝酵母菌9株,霉菌3株,近平滑假丝酵母菌2株。革兰阳性菌种金黄色葡萄球菌、表皮葡萄球菌、肺炎球菌对利奈唑胺、万古霉素、替加环素、庆大霉素、头孢吡肟较为敏,而对克林霉素、青霉素G、氨苄西林、头孢唑林耐药。革兰阴性杆菌中较多的菌株为肺炎克雷伯菌肺炎亚种、铜绿假单胞菌、鲍曼不动杆菌复合菌,对氨曲南、氨苄西林舒巴坦、头孢吡肟、头孢他啶、左氧氟沙星、环丙沙星等药物较为敏感,而对头孢替坦、头孢唑林、头孢曲松、呋喃妥因较为耐药。结论:对下呼吸道感染患者进行细菌培养及耐药试验,能够指导临床选择敏感的抗生素,避免盲目用药,减少抗生素的滥用,提高临床治疗效果。Objective:To analyze the bacterial culture and drug resistance of sputum specimens of 120 patients with lower respiratory tract infection.Methods:A total of 120 patients with lower respiratory tract infectionwho admitted in the Chengdu Angel Women's and Children's Hospital from September 2020 to September 2021 were selected.The purulent sputum was selected for smearing,and after Gram staining,microscopic examination was performed,and bacterial culture,strain identification and drug susceptibility tests were performed.Results:Among the 120 patients,72 strains of Gram-negative bacilli were detected,including 24 strains of Acinetobacter baumannii complex,17 strains of Klebsiella pneumoniae subspecies pneumoniae,24 strains of Pseudomonas aeruginosa,5 strains of Enterobacter cloacei complex and 2 strains of ESBL+.The detection rate of Gram-negative bacilli was 60.0%.Among the 120 patients,8 strains of Gram-positive bacteria were detected,with the detection rate of 6.7%,including 4 strains of Staphylococcus aureus,2 strains of Staphylococcus epidermidis,2 strains of pneumococcus.A total of 40 strains of fungi were detected,and the detection rate of fungi was 33.3%,including 26 strains of Candida albicans,9 strains of Candida clorus,3 strains of mold,and 2 strains of candida albicans.Gram-positive strains staphylococcus aureus,Staphylococcus epidermidis and pneumococcus were sensitive to linezolid,vancomycin,tigecycline,gentamicin and cefepime,but resistant to clindamycin,penicillin G,ampicillin and cefazolin.The most common Gram-negative bacilli Klebsiella pneumoniae subsp pneumoniae,Pseudomonas aeruginosa and Acinetobacter baumannii compound bacterium were sensitive to Aztreonam,Ampicillin Sulbactam,cefepime,Ceftazidime,Levofloxacin,ciprofloxacin and other drug,but more resistant to Cefotetan,Cefazolin,Ceftriaxone,Nitrofurantoin.Conclusion:Bacterial culture and drug resistance experiment for patients with lower respiratory tract infection can guide clinical selection of sensitive antibiotics,avoid blind drug applicati

关 键 词：下呼吸道感染 痰标本 细菌培养 耐药试验 

分 类 号：R446.5[医药卫生—诊断学] R56[医药卫生—临床医学]