下呼吸道感染分离革兰阴性杆菌的耐药性分析

目的分析我院下呼吸道感染患者临床分离常见革兰阴性细菌对常用抗菌药物的耐药性,指导临床合理使用抗菌药物。方法收集下呼吸道感染患者痰或支气管肺泡灌洗液,常规细菌培养、分离后,经VITEK-AMS 60自动分析仪鉴定,应用K-B法测定对抗菌药物的敏感性。结果临床分离常见革兰阴性杆菌前3位依次为不动杆菌属（25.4%）、铜绿假单胞菌（16.2%）、肺炎克雷伯杆菌（15.4%）。不动杆菌属细菌对第3代头孢菌素中的头孢哌酮/舒巴坦（4.0%）和头孢他啶（4.0%）、第4代头孢菌素（4.0%）、氟喹诺酮类（10.8%）、氨基糖甙（10.8%）及亚胺培南（9.5%）耐药率较低。铜绿假单胞菌对头孢吡肟耐药率最低（4.3%）,其次分别是左氧氟沙星（19.1%）、阿米卡星（25.2%）、环丙沙星（25.5%）,对亚胺培南的耐药率高达55.3%。肺炎克雷伯杆菌除哌拉西林耐药率19.1%外,对常用抗生素的耐药性相对较低。结论我院下呼吸道感染分离革兰阴性杆菌以不动杆菌位居首位,常见革兰阴性杆菌对抗生素呈不同程度耐药性。铜绿假单胞菌对亚胺培南耐药现象十分严重,应根据药敏结果用药。加强对院内感染和本地区、本院及本病区临床分离菌的耐药监测,对合理经验选择抗生素非常重要。

Analysis of antibiotic resistance of gram-negative bacilli isolated from lower respiratory tract infections

Objective To analyze the resistance of antibiotics of gram-negative bacilli isolated from patients with lower respiratory tract infection and help clinicians using antibiotics properly.Methods Isolates from patients' sputums or bronchoalveolar lavage fluids(BALF) were collected,and identified with VITEK-AMS 60 autoanalyzer system,the susceptibilities to antibiotics were detected by Kirby-Bauer method.Results The most common three gram-negative bacilli from lower respiratory tract infections were Acinetobact...