下呼吸道感染患者痰液分离菌及其耐药性

目的对呼吸科住院患者的痰液分离菌及部分细菌的耐药性进行分析，为合理选用抗菌药物提供依据。方法收集患者的合格痰标本行细菌培养与分离鉴定，并作药敏实验。结果分离到细菌888株，革兰阳性菌占20.9%，主要为肺炎链球菌(9.2%)；革兰阴性菌占79.1%，主要为流感嗜血杆菌(12.3%)、铜绿假单胞菌(17.2%)、肺炎克雷白杆菌(11.3%)等。肺炎链球菌对青霉素和红霉素的耐药率分别已达38.9%和76.7%。流感嗜血杆菌对氨苄西林、头孢呋辛、头孢噻肟和环丙沙星的耐药率分别达48.5%，14.3%，14.0%和39.8%。肺炎克雷白杆菌对氨苄西林、环丙沙星、阿莫西林/克拉维酸的耐药率分别达98.8%，28.1%，31.9%。铜绿假单胞菌对环丙沙星、头孢他啶和亚胺培南的耐药率也分别达25.5%，28.4%和24.0%。结论应尽可能获得病原学诊断，并及时了解本地区本医院的细菌耐药情况，以便及时调整治疗方案。

Analysis and of Bacteria Their Antibiotic Resistance in Lower Respiratory Infection

Objective In order to use antibiotics more rationally, we investigated the bacteria and their antibiotic resistance in lower respiratory tract infections in hospital. Methods Standard microscopy, culture and drug sensitivity were performed with the bacteria of sputum samples collected from inpatients with lower respiratory tract infections from July 1998 to December 2002. Results There were 888 strains isolated. The Gram positive rate was 20.9%, mainly composed of streptococcus pneumoniae (9.2%). The Gram negative rate was 79.1%,mainly composed of heamophilus influenzae ((12.3%)), pseudomonas aeruginosa (17.2%) and Klebsiella pneumoniae (11.3%). The resistance rates of the streptococcus pneumoniae to penicillin and erythromycin were 38.9% and 76.7%. The resistance rates of heamophilus influenzae to ampicillin, cefuroxime, cefotaxime and ciprofloxacin were 48.5%, 14.3%, 14.0% and 39.8%. The resistance rates of Klebsiella pneumoniae to ampicillin, ciprofloxacin and amoxicillin-clavulanate were 98.8%, 28.1% and 31.9%. The resistance rates of pseudomonas aeruginosa to ciprofloxacin, ceftazidime and imipenem were 25.5%, 28.4% and 24.0%. Conclusion The antibiotic resistance of the bacteria in lower respiratory infections suggests we must be aware of the bacteria resistance to avoid the irrational use of antibiotics, and we must adjust the therapy regimen by drug sensitivity to the pathogen bacteria.