下呼吸道感染病原菌分布及其药物敏感性分析

目的了解呼吸内科住院患者下呼吸道感染的病原菌分布及药物敏感情况,为下呼吸道感染的抗菌药物选择提供指导。方法回顾性分析呼吸内科2013年7月至2015年6月住院下呼吸道感染患者痰培养结果,并对致病菌的药物敏感性进行分析。结果共分离出病原菌395株,其中G-杆菌共274株,占69.4%,G+球菌共30株,占7.6%,真菌共91株,占23.0%。G-杆菌以铜绿假单胞菌(75株)、鲍曼不动杆菌(75株)、肺炎克雷伯杆菌(62株)为主要致病菌。G+球菌以金黄色葡萄球菌(16株)为主要致病菌。所分离的主要G-杆菌对多种抗菌药的敏感性较低,除肺炎克雷伯杆菌外,对亚胺培南的敏感率在70%以下。金黄色葡萄球菌对万古霉素、替考拉宁、利奈唑胺敏感率均100%。真菌以白假丝酵母菌为主(80株),对抗真菌药物普遍敏感。结论呼吸内科住院患者下呼吸道感染患者的病原菌主要为G-杆菌,构成复杂,耐药率高,临床应动态监测病原体及其药物敏感性,指导临床抗菌药物的合理选择。

Distribution and drug sensitivity of pathogenic bacteria of lower respiratory tract infection

Objective To investigate the distribution and drug sensitivity of primary pathogens in patients with lower respiratory tract infection and to provide evidences for clinical therapy. Methods By retrospective analy-sis of the distribution and drug sensitivity of primary pathogens, sputum samples were collected from hospitalized pa-tients with lower respiratory tract infection from July 2013 to June 2015. Results There were 395 strains of patho-genic bacteria in the sputum specimens. Among them, there are 274 strains of gram-negative bacteria (69. 4%), 30 strains of gram-positive bacteria (7. 6%), and 91 strains of fungus (23%). The main gram-negative bacteria were Pseudomonas aeruginosa ( 75 strains ) , Bauman Acinetobacter ( 75 strains ) , and Klebsiella pneumoniae ( 62 strains). The main gram-positive bacteria were Staphylococcus aureus (16 strains). The main gram-negative bacteria showed a low sensitivity to many antibiotics. Their drug sensitivity to imienem were below 70%, except for Klebsiella pneumoniae. The main gram-positive bacteria were sensitive to Vancomycin, Teicoplanin and Linezolid. Monilia albi-cans were sensitive to most anti-fungal drugs. Conclusion The composition of pathogenic bacteria from lower re-spiratory infection in our hospital is complex, and the gram-negative bacillus is the main pathogen, with high bacterial resistance. Pathogen detection and drug sensitivity monitoring should be enhanced with the hope to direct the rational use of antibacterials in clinic.