摘要
目的了解安徽医科大学第一附属医院住院患者2009-2013年下呼吸道感染主要病原菌的分布和耐药性,为临床合理应用抗菌药物提供依据。方法收集我院住院患者痰培养及药敏结果,分析下呼吸道感染主要病原菌的分布和耐药性。结果我院下呼吸道感染常见病原菌以革兰阴性菌为主,占90.6%,主要病原菌为鲍曼不动杆菌(22.2%),铜绿假单胞菌(19.9%)、肺炎克雷伯菌(15.3%)、大肠埃希菌(7.5%)、嗜麦芽窄食单胞菌(6.2%)、阴沟肠杆菌(5.2%);革兰阳性菌占9.4%,主要病原菌为金黄色葡萄球菌(7.6%)、肺炎链球菌(1.2%)、屎肠球菌(0.2%)。耐药性分析结果显示:鲍曼不动杆菌对米诺环素、头孢哌酮/舒巴坦耐药率<27%;铜绿假单胞菌对哌拉西林耐药率高达98.5%,对头孢吡肟、头孢哌酮/舒巴坦、阿米卡星耐药率<19%;嗜麦芽窄食单胞菌对左氧氟沙星、米诺环素耐药率在15%左右;大肠埃希菌和肺炎克雷伯杆菌对β-内酰胺酶抑制剂复方制剂具有较高的敏感性,耐药率在15%左右,大肠埃希菌对碳青霉烯类耐药率<5%,肺炎克雷伯杆菌对碳青霉烯类耐药率<10%;葡萄球菌属对氨基苷类、喹诺酮类、头孢菌素类抗生素耐药率>60%,未发现万古霉素、利奈唑胺、替加环素耐药株。结论下呼吸道感染病原菌以革兰氏阴性菌为主,耐药率高,应根据药敏结果合理选择抗生素指导治疗,以提高疗效及减少耐药菌株的产生。
Objective To investigate the bacterial distribution and drug resistance of lower respiratory tract infection in our hospital from 2009-2014, in order to provide the basis for clinical rational use of antibiotics. Methods The sputum specimens were cultured and given drug sensitivity test. Then the bacterial distribution and drug resistance of lower respiratory tract infection were analyzed. Results The main pathogens of lower respiratory tract infection in our hospital were gram-negative bacteria, accounting for 90.6%, which included acinetobacter banmannii （22. 2% ）, pseudomonas aeruginosa （ 19.9% ）, klebsiella pneumaniae （ 15.3% ）, escherichia coil （7.5%）, mal- tophilia aeromonas （6. 2% ） and enterobacter cloacae （5.2%）. Gram-positive bacteria accounted for 9. 4%, which included staphylococcus aureus （7.6%） , streptococcus pneumoniae （1.2%） and feces enterococci （0. 2% ）. The drug-resistant test showed that the resistance of acinetobacter baumannii to minocycline, cefoperazone/sulbactam was lower than 27%, the resistance of pseudomonas aeruginosa to piperacillin was up to 98. 5%, and to cefepime, cef- operazone/sulbactam and amikacin was lower than 19%. The resistance of maltophilia aeromonas to levofloxacin and minocycline was about 15%. The resistance of escherichia coli and klebsiella pneumoniae to 13-1actamase inhibitor compound was around 15%. The resistance of escherichia coli to carbapenems was lower than 5%. The resistance of klebsiella pneumoniae to carbapenem was lower than 10%. The resistance of staphylococcus to aminoglycoside, quin- olones and cephalosporins was higher than 60%. There was no vancomycin, linezolid, tigecycline-resistant strains found. Conclusion The main pathogens of lower respiratory tract infection are gram-negative bacteria, showing a high resistance. Therefore, the use of antibiotics should be based on drug-resistant tests, in order to improve the effi- cacy and reduce the generation of resistant strains.
出处
《临床肺科杂志》
2015年第3期461-464,共4页
Journal of Clinical Pulmonary Medicine
关键词
呼吸道感染
病原菌
耐药性
lower respiratory tract infection pathogens drug resistance
