下呼吸道感染病原菌分布及药敏分析

目的探讨下呼吸道感染患者的病原菌种类分布及其耐药性,为临床合理用药提供依据。方法对2011年1～12月邳州市人民医院下呼吸道感染患者痰标本分离出的病原菌进行菌种分布和耐药性回顾性分析。结果共分离出336株病原菌,其中革兰阴性菌185株（55.1%）;革兰阳性菌78株（23.2%）;真菌73株（21.7%）。主要革兰阴性菌依次为铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌,对常用抗菌药物呈现较高的耐药性,对亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦耐药性较低。革兰阳性菌以金黄色葡萄球菌、肺炎链球菌为主,也显示较高的耐药率,未发现对万古霉素耐药的菌株。真菌以白假丝酵母、热带假丝酵母及曲霉菌为主。结论下呼吸道感染中以革兰阴性杆菌为主,主要的病原菌对临床常用抗菌药物耐药呈现较高的耐药性,加强下呼吸道感染的病原学检查及耐药性监测至关重要。

Analysis of pathogens distribution and drug resistance in lower respiratory tract infection

Objective To analyze the pathogens distribution and antibiotic resistance in the patients with lower respiratory tract infection for rational antimicrobial theraphy.Methods Bacteria culture and drug sensitivity test of sputum samples of patients with lower respiratory tract infection from January 2011 to December 2011 in our hospital were analyzed retrospectively.Results Totally 336 pathogenic bacteria were separated,it included 185（55.1%） strains of Gram-negative bacilli,78（23.2%） strains of Gram-positive bacteria and 73（21.7%） strains of fungi.The most predominant Gram-negative bacteria isolates in order of frequency were P.aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii.The resistance rates of Gram-negative bacteria to the commonly used antibiotics were very high.Imipenem,cefoperazone/sulbactam and piperacillin/tazobactam were effective antibiotics for treating Gram-negative bacteria infection.Staphylococcus aureus and Streptococcus pneumoniae were the main gram-positive cocci,and the resistance rates of them to the commonly used antibiotics were also high.No strains of gram-positive cocci isolated were resistant to vancomycin.Conclusion Gram-negative bacilli are main pathogens in lower respiratory tract infection and the antibiotic resistance grows more prevalent in some main pathogen strains.It is very important to emphasize pathogenic bacterium monitoring and pay attention to supervising drug resistance.