摘要
目的了解我院下呼吸道感染患者的病原菌分布及其耐药情况,为临床合理选用抗菌药物提供用药参考。方法回顾性分析1 263例下呼吸道感染患者的病原菌分布及其耐药性。结果 1 263例痰标本共分离出病原菌453例,其中革兰氏阴性菌(G-)317例(70.0%),革兰氏阳性菌(G+)91例(20.1%),真菌45例(9.9%)。位列前6位的病原菌依次为肺炎克雷伯菌、流感嗜血杆菌、肺炎链球菌、大肠埃希菌、铜绿假单胞菌和金黄色葡萄球菌。药敏结果显示G-对亚胺培南,头孢吡肟耐药率最低,其次为哌拉西林他唑巴坦、头孢哌酮舒巴坦、头孢他啶、头孢唑肟等;G+对去甲万古霉素耐药率最低,其次为头孢唑林、头孢拉定、头孢呋辛、苯唑西林等;真菌对氟康唑、两性霉素B等均较为敏感。结论我院下呼吸道感染病原菌以G-为主,其次是G+、真菌。经验治疗可选择头孢三代,哌拉西林他唑巴坦,苯唑西林等抗菌药物。多重耐药菌可根据药敏结果选择头孢四代、亚胺培南、去甲万古霉素等治疗或联合用药。
Objective To analyze the pathogens distribution and drug resistance in patients with lower respiratory tract-infections in the hospital so as to provide appropriate clinical treatment. Methods By retrospective analysis of 1 263 cases of pathogens distribution and drug resistance in patients with lower respiratory tract infections. Results There were 453 cases with pathogenic bacteria in the sputum specimens. Among them there were317 Gram-negative bacteria（G-） cases（accounting for 70.0%）, 91 Gram-positive bacteria（G＋） cases（20.1%）, and 45 fungus cases（9.9%）. The top six of pathogens were Klebsiella pneumoniae, Haemophilus influenzae, Streptococcus pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus. The results of drug susceptibility test showed that G-were most sensitive to imipenem, cefepime, followed by piperacillin tazobactam, cefoperazone sulbactam, ceftazidime, and ceftizoxime; G＋were most sensitive to norvancomycin, cefazolin, cephradine, cefuroxime, and oxacillin; while fungi were sensitive to both fluconazole and amphotericin B. Conclusion In all the pathogens of lower respiratory tract infection, G-was in the majority, followed by G＋and the fungi. Therefore, third generation cephalosporin, piperacillin-tazobactam and oxacillin can be adopted in the empiric treatment. While with multiple resistant bacteria, fourth generations cephalosporin, imipenem, norvancomycin, or combination of drugs can be considered according to the susceptibility results.
出处
《海南医学》
CAS
2014年第22期3336-3339,共4页
Hainan Medical Journal
关键词
下呼吸道感染
抗菌药物
病原菌
耐药性
药敏
Lower respiratory tract infection
Antimicrobial agents
Pathogenic bacterium
Drug resistance
Drug susceptibility
