我院呼吸系统感染病原菌分布及耐药情况分析

目的:了解呼吸系统感染的病原菌分布及耐药情况,为临床合理应用抗菌药物提供参考。方法:对我院2008年1月～2009年12月3216例自痰液标本分离的1891株病原菌作回顾性分析。结果:检出致病菌中,革兰阴性菌占52.33%、革兰阳性菌占5.65%、真菌占42.02%;主要病原菌分布:白色念珠菌占31.15%、铜绿假单胞菌占12.06%、肺炎克雷伯菌肺炎亚种占11.21%;主要病原菌对药物的耐药率:白色念珠菌<2%、铜绿假单胞菌为0～42.5%,大肠埃希菌除头孢他啶及第4代头孢<20.0%,其它为42.86%～88.10%。β-内酰胺酶抑制剂能明显降低肠杆菌的耐药率,降低幅度为40%～80%。结论:呼吸系统二重感染严重,大肠埃希菌耐药严重,应加强临床呼吸系统感染病原菌的耐药性检测及预警,指导临床合理应用抗菌药物。

Distribution of Pathogenic Bacteria of Respiratory Infection and Rational Use of Antimicrobial Agents in Our Hospital

OBJECTIVE：To understand the distribution of pathogens causing respiratory infection and drug resistance in order to provide reference for rational use of antimicrobial agents.METHODS：From Jan.2008 to Dec.2009,1 891 isolated pathogens of 3 216 sputum samples were analyzed retrospectively.RESULTS：Among detected pathogens,Gram-negative bacteria accounted for 52.33%,Gram-positive bacteria 5.65% and fungi 42.02%;the main distribution of pathogenic bacteria：Candida albicans of 31.15%,Pseudomonas aeruginosa of 12.06%,Klebsiella pneumoniae subspecies of 11.21%;the main drug resistance rate of pathogens：that of Candida albicans was below 2%,Pseudomonas aeruginosa of 0～42.5%,Escherichia coli except ceftazidime and fourth generation cephalosporins below 20.0% and others of 42.86%～88.10%,respectively.β-lactamase inhibitor can significantly reduce the drug resistance of enterobacteria which decreased by 40%～80% or more.CONCLUSION：There are severe respiratory superinfection and drug resistant of Escherichia coli.We should strengthen the drug resistance detection and early warning for pathogenic bacteria of respiratory system infection to guide rational use of antimicrobial agents.