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1.
目的 了解老年患者下呼吸道感染病原菌分布及耐药性.方法 对老年患者下呼吸道感染的痰标本进行培养分离致病菌株进行鉴定和药敏试验.结果 共分离出病原菌386 株,其中革兰阴性杆菌291 株,革兰阳性球菌70株,真菌25株;常见的病原菌为铜绿假单胞菌、肺炎克雷伯菌和大肠埃希菌.真菌感染呈上升趋势.分离病原菌耐药率分析发现,对β-内酰胺类抗生素耐药性严重,万古霉素、替考拉宁、亚胺培南耐药率低.结论 老年患者下呼吸道感染以革兰阴性杆菌为主,而且耐药性较强.  相似文献   

2.
目的:分析心血管科住院患者医院感染病原菌分布情况及耐药性,为临床治疗提供重要参考依据。方法选取于2012年2月-2014年1月在我院接受治疗的心血管科住院患者的血液、痰液、尿液、留置导管等各类感染性标本,进行病原菌的常规分离培养,统计分析分离病原菌的分布及药敏结果。结果获得了无重复分离病原菌250株,呼吸道感染病原菌共155株,静脉导管末端掺病原菌20株,尿液病原菌10株;胸腔积液病原菌15株,血液病原菌40株;其他部位标本共10株,其中革兰阴性杆菌190株,革兰阳性球菌40株,真菌占40株;大肠埃希菌对氨苄西林耐药性较高,肺炎克雷伯菌对氨曲南第3代头孢菌素耐药性较高,铜绿假单胞菌对头孢他啶、头孢吡肟、阿米卡星、亚胺培南、哌拉西林以及他唑巴坦的耐药性较低。结论心血管科患者医院感染的主要病原菌是肺炎克雷伯菌和鲍曼不动杆菌以及大肠埃希菌,其多种耐药情况严重,在临床上应引起重视。  相似文献   

3.
目的 探讨高龄老年人医院获得性肺炎(HAP)常见病原菌及其耐药性.方法 对医院干部病房73例高龄老年HAP患者的临床资料、痰标本中分离出的病原菌及其耐药性进行回顾分析.结果 共分离出164株病原菌,革兰阴性菌103株(62.80%),革兰阳性菌38株(23.17%),真菌23株(14.03%).前5种病原菌分别为铜绿假单胞菌(23.78%)、肺炎克雷伯菌(17.07%)、真菌(14.03%)、金黄色葡萄球菌(12.20%)、大肠埃希氏菌(9.15%).革兰阴性杆菌和革兰阳性杆菌普遍呈现多耐药性.结论 高龄老年HAP病原菌以革兰阴性菌为主,病原菌多药耐药现象严重,真菌感染呈现上升趋势,须引起老年病医生高度重视.及时掌握HAP的常见病原菌及药敏情况对临床正确应用抗菌药物具有重要的指导作用.  相似文献   

4.
葛怡 《临床肺科杂志》2012,17(12):2271-2272
目的通过探讨重症监护病房(ICU)呼吸机相关性肺炎(VAP)的病原菌组成及耐药性。方法通过对我院ICU患VAP的73例患者进行回顾性分析,取患者痰液标本分离病原菌并进行耐药性分析。结果我院患者痰液中共检出VAP病原菌183株,其中以革兰氏阴性菌为主共134株,而铜绿假单胞菌占首位;革兰氏阳性菌31株,以金黄色葡萄球菌为主;真菌18株,白色念珠菌为主。各种病原菌均对常规抗菌药物出现耐药性,且多重耐药性严重。结论 ICU呼吸机相关肺炎病原菌分离及耐药性研究,为VAP临床防治策略提供依据,对VAP防治具有重要意义。  相似文献   

5.
目的分析心血管内科肺部感染患者病原菌分布及耐药性,为临床医师合理选择药物治疗提供依据。方法选择2014年1月~2014年12月我院收治的心血管内科肺部感染患者128作为观察对象,收集患者的痰液标本进行病原菌培养试验以及药物敏感性试验,对分离培养结果进行分析。结果 128例标本分离得到184株无重复病原菌。其中革兰阴性菌99株、革兰阳性菌58株、真菌27株。分离率最高病原菌为肺炎克雷伯菌、大肠埃希菌以及铜绿假单细胞杆菌。肺炎克雷伯菌以及大肠埃希菌对于第三代头孢菌素、喹诺酮类以及氨基糖苷类抗菌药的耐药性高;铜绿假单细胞杆菌对于头孢唑啉的耐药率为100%;革兰阳性菌对左氧氟沙星、青霉素、克林霉素以及红霉素的耐药率均超过80%。结论心血管内科肺部感染患者的主要病原菌为革兰阴性菌,掌握具体的病原菌种类、分析其耐药性对于抗菌药物的选择具有重要意义。  相似文献   

6.
目的了解2010~2011年医院呼吸科下呼吸道感染患者痰液病原菌类型及耐药性变迁情况。方法分离送检痰液病原菌,采用API系统鉴定菌种,纸片扩散法(K-B法)进行药物敏感试验,对常见病原菌耐药性变迁情况进行分析。结果 2010~2011年呼吸科送检痰标本1 560份,检出病原菌501株,检出率32.12%,其中革兰阳性菌184株,占36.72%,革兰阴性菌296株,占59.08%,真菌21株,占4.19%。分离菌株数居前4位病原菌分别为铜绿假单胞菌(98株)、肺炎克雷伯菌(81株)、金黄葡萄球菌(78株)和大肠埃希菌(61株)。革兰阴性菌对万古霉素、亚胺培南、苯唑西林、头孢哌酮/舒巴坦、氨曲南的耐药率较低;金黄葡萄球菌对亚胺培南、万古霉素、苯唑西林的耐药率为较低,对其他抗菌药物均呈现出较高的耐药性。病原菌的耐药率2011年高于2010年。结论呼吸科痰液分离病原菌以革兰阴性菌为主,分离菌对常见抗生素的耐药明显,且呈逐年升高趋势。  相似文献   

7.
目的了解江苏省仪征市腹泻发病及致病菌感染、菌型分布、可疑食物等情况,掌握食源性疾病流行特征、确定危险因素及防治重点,提高对食源性疾病的预警、预防和控制能力。方法对2010年辖区内监测点医院肠道门诊就诊的腹泻患者进行登记,对有明确可疑食物史的患者采集粪便标本,检测沙门菌、副溶血性弧菌、志贺菌、霍乱弧菌,并进行统计分析。结果 2010-04/11共监测肠道门诊腹泻患者粪便样115人,在115份粪便标本中,分离培养出14株副溶血性弧菌,志贺菌1株(宋内志贺菌),沙门菌1株(阿贡纳沙门菌)共有16份标本检出致病菌。结论 2010年仪征市监测点医院115例腹泻患者病原菌主要为副溶血性弧菌。  相似文献   

8.
目的 了解败血症病原菌分布及其耐药性的变化,指导临床合理用药.方法 应用全自动血培养仪对520例疑似败血症患者外周血标本进行培养,使用Vitek AMS系统对培养阳性者进行病原菌鉴定,采用K-B法进行体外药敏试验,并采用体外扩散确证法进行ESBLs检测.结果 520例外周血标本中检出107株(20.6%)病原菌,从中分离出革兰阴性菌56株(52.3%),革兰阳性菌40株(37.4%),真菌11株(10.3%).引起败血症的主要病原菌依次为大肠埃希菌(28株,26.2%)、葡萄球菌(25株,23.4%)、克雷伯菌(11株,10.3%);28株大肠埃希菌和11株克雷伯菌中分别确证ESBLs阳性菌13株和3株,检出率分别为46.4%和27.3%.ESBLs阳性菌株对多种抗生素耐药,其耐药率明显高于ESBLs阴性菌株.结论 革兰氏阴性菌是败血症的主要致病菌,大肠埃希菌是最常见的病原菌.导致败血症的病原菌常存在多重耐药性,产ESBLs是大肠埃希菌耐药的重要原因.应加强对病原菌ESBLs的监测,预防和控制耐药菌株的传播流行.  相似文献   

9.
目的观察我科RICU住院患者感染病原菌特点及其耐药情况。方法分析480例RICU住院患者,观察感染率、病原菌分布及耐药性。结果从送检的标本中共检出病原菌276株,其中革兰阳性菌121株,以肺炎链球菌和金黄色葡萄球菌为主,革兰阴性菌149株,以铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌及大肠埃希菌为主,真菌6株,均为白色假丝酵母菌。药物敏感试验显示,分离得到的病原菌绝大多数呈现多重耐药性,尤其是对临床上最常使用的头孢三代抗菌药物有较高的耐药率。结论 RICU患者感染率较高,经验用药的同时,应加强病原菌的耐药性监测,以指导临床合理使用抗菌药物。  相似文献   

10.
目的探讨高龄老年人医院获得性肺炎(HAP)常见病原菌及其耐药性。方法对医院干部病房73例高龄老年HAP患者的临床资料、痰标本中分离出的病原菌及其耐药性进行回顾分析。结果共分离出164株病原菌,革兰阴性菌103株(62.80%),革兰阳性菌38株(23.17%),真菌23株(14.03%)。前5种病原菌分别为铜绿假单胞菌(23.78%)、肺炎克雷伯菌(17.07%)、真菌(14.03%)、金黄色葡萄球菌(12.20%)、大肠埃希氏菌(9.15%)。革兰阴性杆菌和革兰阳性杆菌普遍呈现多耐药性。结论高龄老年HAP病原菌以革兰阴性菌为主,病原菌多药耐药现象严重,真菌感染呈现上升趋势,须引起老年病医生高度重视。及时掌握HAP的常见病原菌及药敏情况对临床正确应用抗菌药物具有重要的指导作用。  相似文献   

11.
北京地区1994-2005年腹泻病原菌的分布及其耐药趋势   总被引:3,自引:0,他引:3  
Qu F  Mao YL  Cui EB  Guo TS  Bao CM  Liu LM  Li XH  Li B 《中华内科杂志》2008,47(4):304-307
目的 监测我院1994-2005年与腹泻有关的肠道致病菌的分布及耐药趋势,为本地区流行病学研究、疫苗制备及临床合理用药提供依据.方法 通过常规大便培养,筛出致病菌后经生化及血清学进一步鉴定到种、群或血清型,并以纸片扩散法测定抗菌药物的敏感性.结果 12年分离到肠道病原菌8426株,患者以男性为主,儿童和青年发病为多,每年7~9月为腹泻发病高峰.病原以志贺菌属居首位(占75.11%),其次是弧菌(占12.70%),再依次为沙门菌属、气单胞菌、致病及侵袭大肠埃希菌分别占6.28%、4.43%及1.25%.6329株志贺菌中,福氏志贺菌占75.62%,其次是宋内菌群(23.98%),痢疾志贺菌及鲍氏志贺菌分别占0.22%及0.01%.12年的变化趋势是,每年肠道病原菌总数在逐渐减少,特别是志贺菌、沙门菌减少明显,而弧菌及气单胞菌相对逐渐增多.各菌属及不同的血清型对抗菌药物的敏感率有差异,福氏志贺菌和气单胞菌属多重耐药较多,而宋内志贺菌和弧菌属对多数抗菌药物敏感.结论 北京地区感染性腹泻的病原种类多,随时间的变迁病原变化明显,耐药性不同,应重视监测.  相似文献   

12.
Enteropathogenic microorganisms isolated from feces of 9,393 patients with diarrhea or enteritis in our hospital between 1976 and 1988 were analyzed. As the result of the examination of 5,443 outpatients, 1,811 strains of pathogens were isolated from 1,686 cases (31.0%). Several species including Salmonella spp., Escherichia coli serotype, Vibrio parahaemolyticus, were isolated before 1978, and the incidence of pathogens was low (14.8%). For the 10-year period since 1979, the incidence markedly increased to 34.4%, and the number of pathogens isolated also increased to about twice that before 1978. The main cause of the increase was Campylobacter species. The major pathogens detected since 1979 were Campylobacter spp., E. coli serotype, Salmonella spp., V. parahaemolyticus, etc., but Rota virus, Clostridium difficile, Aeromonas spp., Vibrio fluvialis, etc. have also been detected, showing an increase in the number and diversity of the detected pathogens. As the result of the examination of 3,950 inpatients, 835 strains of pathogens were isolated from 800 cases (20.3%). The incidence of C. difficile was the highest, 423 of 800, followed by E. coli serotype, Salmonella spp., Campylobacter spp., V. parahaemolyticus and Aeromonas spp., in that order. All the inpatients from whom C. difficile was isolated manifested diarrhea or enteritis after administration of antimicrobial agents. The pathogens causing communicable disease were Salmonella spp. serovar Typhi, Salmonella spp. serovar Paratyphi A, Shigella flexneri, Shigella sonnei and Entamoeba histolytica, which were isolated from 5, 1, 3, 2 and inpatients, respectively.  相似文献   

13.
Two hundred patients with diarrhoea in a rehabilitation camp in Ethiopia were studied in October 1985 to determine the presence of pathogens in the stool and their susceptibility to antibiotics. A total of 42 (21.1%) patients had a positive culture with enterobacteriaceae, the isolation rate was 15.6% for Escherichia coli, 3.5% for Shigella spp. and 2.01% for Salmonella spp. In-vitro antibiotic resistance was frequent among the 42 isolates: 53% of E. coli strains were found to be resistant to ampicillin, 47% to chloramphenicol, 30% to co-trimoxazole and 67% to tetracycline. Of the seven Shigella, three were resistant to chloramphenicol and four to tetracycline. Multidrug resistance (two or more antibiotics) was observed in 52.3% of the 42 isolates. The protocols used for the screening of dysenteric patients for Shigella spp. or Salmonella spp. were found to be specific but poorly sensitive. The opposite was observed for amoebiasis and giardiasis. The responsibility of widespread use of common oral antibiotics is discussed as one of the major factors of antibiotic resistance occurrence at Korem.  相似文献   

14.
The antimicrobial susceptibility patterns for 2,812 bacterial pathogens isolated from diarrheal patients admitted to hospitals in several provinces in the cities of Jakarta, Padang, Medan, Denpasar, Pontianak, Makassar, and Batam, Indonesia were analyzed from 1995 to 2001 to determine their changing trends in response to eight antibiotics: ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, tetracycline, cephalothin, ceftriaxone, norfloxacin, and ciprofloxacin. Vibrio cholerae O1 (37.1%) was the pathogen most frequently detected, followed by Shigella spp. (27.3%), Salmonella spp. (17.7%), V. parahaemolyticus (7.3%), Salmonella typhi (3.9%), Campylobacter jejuni (3.6%), V. cholerae non-O1 (2.4%), and Salmonella paratyphi A (0.7%). Of the 767 Shigella spp. isolated, 82.8% were S. flexneri, 15.0% were S. sonnei, and 2.2% were S. dysenteriae (2.2%). The re-emergence of Shigella dysenteriae was noted in 1998, after an absence of 15 years. Shigella spp. were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline. Salmonella typhi and Salmonella paratyphi A were susceptible to all antibiotics tested, while Salmonella spp. showed various resistance patterns according to species grouping. A small number of V. cholerae O1 were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline; however, they were still sensitive to ceftriaxon, norfloxacin, and ciprofloxacin. Similar results were shown for V. cholerae non-O1. Campylobacter jejuni showed an increased frequency of resistance to ceftriaxone, norfloxacin, and ciprofloxacin, but was susceptible to erythromycin. This study shows that except for C. jejuni and V. parahaemolyticus, which appeared to be resistant to ciprofloxacin, the majority of the enteric pathogens tested were still susceptible to fluoroquinolones.  相似文献   

15.
目的:分析我国近5年社区获得性细菌性腹泻病原菌分布及耐药特点。方法收集2009-2013年我国16省市分离自社区获得性细菌性腹泻患者新鲜大便标本的病原菌,用沙门、志贺菌属琼脂培养基、麦康凯培养基和庆大霉素培养基分离培养,挑取疑似腹泻病原菌的纯菌落用VITEKⅡ细菌鉴定仪和微量编码生化反应管鉴定,再以沙门菌、志贺菌、弧菌和致泻性大肠埃希菌血清凝集试验进行血清型分型;采用K-B法检测细菌的药物敏感性(药敏)。结果5年间共收集到我国16个省市各类腹泻病原菌10881株,包括7个菌属、22个菌种和90个血清型,其中志贺菌7632株(70.14%),弧菌1351株(12.42%),沙门菌981株(9.02%),致泻性大肠埃希菌341株(3.13%),气单胞菌302株(2.78%),邻单胞菌269株(2.47%),小肠结肠耶尔森菌5株(0.05%)。志贺菌血清型以B群中的F2a、F4a和F1a为主,沙门菌血清型以肠炎沙门菌和鼠伤寒沙门菌为主。药敏监测显示,志贺菌对头孢噻肟、头孢吡肟、头孢美唑、亚胺培南和磷霉素等敏感性较好,敏感率分别为89.7%、92.3%、96.7%、100%和97.7%;沙门菌对头孢噻肟、头孢吡肟、氨曲南、亚胺培南和磷霉素等敏感率分别为94.0%、97.9%、94.4%、100%和96.4%;气单胞菌对头孢吡肟、左氧氟沙星、亚胺培南和磷霉素等敏感率分别为80.9%、80.0%、92.6%和84.0%;致泄性大肠埃希菌对抗生素的敏感率普遍较差;弧菌对所测抗生素敏感性(氨苄西林除外)均较好。结论我国社区获得性细菌性腹泻病原菌以志贺菌属、弧菌属和沙门菌属为主,经验性抗生素治疗应该覆盖这些病原,靶向治疗应该考虑药敏试验结果。  相似文献   

16.
During the last 8 years (1984 to 1991), 16,639,233 overseas travellers were quarantined at Osaka Airport Quarantine Station and 38,326 travellers reported that they were (or had been) suffering from diarrhoea. Bacteriological examination of stools from 12,573 persons revealed the following results. 1) Various enteropathogenic bacteria were isolated from 3,669 cases (29.2%) examined. The predominant species of bacteria isolated were as follows: Salmonella, 1049 cases; Plesiomonas shigelloides, 1030 cases; Vibrio parahaemolyticus, 789 cases; Shigella, 607 cases; enterotoxigenic Escherichia coli, 422 cases; Vibrio cholerae non-O1, 212 cases. 2) There were no apparent seasonal variations in the isolation rate of these pathogens. 3) The suspected regions for infection with these pathogens were as follows: a) Salmonella, Enterotoxigenic E. coli and Plesiomonas, mainly South-East and South-West Asia. b) Shigella, South-West Asia, especially India (59.8%). c) V. parahaemolyticus and V. fluvialis, mainly South-East and East Asia. d) V. cholerae non-O1, V. mimicus, almost restricted to Asia, mainly South-East Asia. 4) 22 strains of V. cholerae O1 were isolated and 19 were Ogawa, E1 Tor. Of these strains, 13 were cholera toxin-producing strains and 9 were non-toxigenic strains. 5) Several pathogens (mixed infection) were isolated simultaneously from 670 cases. 6) The 1247 Salmonella strains were identified into 98 serovars. 7) Of 624 Shigella strains isolated, 57.9% were S. sonnei, 29.2% were S. flexneri, 8.6% were S. boydii, 4.3% were S. dysenteriae. 8) The most predominant serovar of V. parahaemolyticus was O4:K8. Of 1,247 strains isolated, 9.8% were not producing thermostable direct hemolysin (TDH). 9) 570 (91.3%) of 624 Shigella strains and 409 (32.8%) of 1,247 Salmonella strains isolated were resistant to any one of the drugs tested (SM. CP. TC. KM. ABPC. NA. OFLX). The resistance rate and the number of multiple drug-resistance strains increased year by year. 10) Enterotoxigenic E. coli was isolated from 422 cases (10.7%) of 3,939 cases. Cases with enterotoxigenic E. coli strains producing ST (heat-stable), LT (heat-labile) or both ST and LT were 53.8%, 24.2% and 14.2% respectively. The others were cases with mixed types of enterotoxin production.  相似文献   

17.
In contrast to prior experience in this setting, three of four Shigella flexneri strains recently isolated from patients in Northeastern Brazil with acute inflammatory diarrhea were found to be resistant to sulfamethoxazole, trimethoprim and the combination in vitro. We performed mating studies to determine if the resistance was transferable, and then isolated and characterized plasmid DNA from the resistant Shigella isolates, other resistant Enterobacteriaceae isolated simultaneously from the stools of these individuals, and transconjugant strains. Each of the resistant Shigella strains contained a large plasmid. These plasmids were of different molecular weights ranging from 30 to 50 Mdal in size. Two of these plasmids were transferred with sulfamethoxazole-trimethoprim resistance to E. coli K-12 recipient strains. These findings of transferable resistance to sulfamethoxazole-trimethoprim associated with plasmids in Shigella and in other Enterobacteriaceae raises concerns about the potential limitations of this widely used antimicrobial combination.  相似文献   

18.
We determined the minimum inhibitory concentrations (MICs) of rokitamycin (TMS-19-Q, RKM), a macrolide antimicrobial agent, against strains of various bacterial species isolated from enteritis patients, and compared them with those of josamycin (JM), erythromycin (EM) and ofloxacin (OFLX). MIC90 of RKM against 147 strains of Campylobacter jejuni, and each 25 strains of Shigella spp., Salmonella spp. and diarrheagenic Escherichia coli were 1.56, 200, 800 and 200 micrograms/ml, respectively. There was only one RKM resistant (MIC greater than 100 micrograms/ml) C. jejuni strain, while most of the strains of the other species were resistant to RKM. MIC values of the other drugs were all similar to those of RKM. MIC90 of OFLX against 147 strains of C. jejuni was 0.78 micrograms/ml, lower than other drugs.  相似文献   

19.
The incidence of transmissible drug resistance among Salmonella isolated from patients with enteric fever and other clinical conditions is reported. All of the Salmonella isolated were studied for antimicrobial resistance. Of the 336 strains, five were multiply resistant to drugs including chloramphenicol, and four of these strains transmitted resistance to Escherichia coli F-Lac+. Multiply drug resistant E. coli were isolated from 12 patients receiving chloramphenicol, and in seven cases the E. coli transmitted drug resistance to sensitive Salmonella isolated from the same patients. The occurrence of multiple drug resistance among Salmonella was not found to be restricted to a single serogroup, and multiple drug resistance in Salmonella paratyphi A in India is reported for the first time. Although the incidence of Salmonella carring R factor is negligible, the unpredictability of its occurrence poses a potential threat in a country where typhoid is endemic.  相似文献   

20.
目的调查泌尿系统感染患者病原菌分布及常用抗生素耐药情况,以指导临床合理用药.方法用无菌方法收集患者尿液标本,采用Vitek-AMS鉴定病原菌和CLSI/NCCLS推荐的纸片扩散法进行药敏试验.结果从1882例患者的尿液标本中分离出1917株病原菌,大肠埃希菌、假丝酵母菌、肠球菌及表皮葡萄球菌分列前4位(32.2%、16.3%、10.8%和8.3%).产超广谱β-内酰胺酶菌株(ESBLs)、耐甲氧西林表皮葡萄球菌(MRSE)、耐万古霉素肠球菌(VRE)和高水平庆大霉素耐药肠球菌(HLGR)检出率分别为30.5%、74.4%、0.78%和72.5%.MRSE和非MRSE对环丙沙星、复方新诺明、庆大霉素、红霉素及克林霉素的耐药率分别为72.3%和24.4%、63.0%和48.8%、37.8%和0、82.4%和68.3%、56.3%和12.2%.HIGR和非HIGR对环丙沙星、青霉素、氨苄西林和呋喃妥因的耐药率分别为86.7%和66.1%、66.0%和39.3%、74.0%和45.6%、19.2%和10.2%.结论大肠埃希菌为泌尿系感染的主要病原菌,假丝酵母菌分离率显著上升;特殊耐药菌株对常用抗菌药物的耐药率明显高于相应的普通菌株.  相似文献   

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