呼吸内科住院患者下呼吸道感染病原菌分布及体外耐药性监测

目的 调查医院呼吸内科住院患者临床感染病原菌的分布及耐药趋势,为临床合理选用抗菌药物提供依据.方法 以回顾性方法,分析从2007年7月1日-2009年6月30日,呼吸内科下呼吸道感染患者送检的痰标本中分离出的病原菌及耐药情况.结果 共分离病原菌1508株,革兰阴性杆菌占47.3%,其中铜绿假单胞菌居于首位,占15.6%;大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)比率为41.0%和35.8%;真菌感染所占比例较高,为44.1%,对氟康唑、酮康唑及两性霉素B均敏感;革兰阳性球菌占8.6%,以金黄色葡萄球菌为主,耐甲氧西林金黄色葡萄球菌占62.4%.结论 呼吸内科病房医院感染的病原菌耐药性日益严重,并有逐年增长趋势,应不断进行耐药性监测,合理使用抗菌药物.

Pathogens Distribution and Antibacterial Resistance in Lower Respiratory Tract Infection from Department of Respiratory Medicine

OBJECTIVE To investigate the tendency of bacterial distribution and drug resistance of pathogens in department of respiratory medicine, then instruct clinical application of antibiotics reasonably. METHODS By the retrospective methods, we analyzed the pathogens isolated from the sputa of the hospitalized patients with lower respiratory tract infection in the department of respiratory medicine from Jul 2007 to Jun 2009 and their drug resistance. RESULTS A total of 1508 strains of pathogens were isolated, Gram-negative bacilli were 47.3%, The most common pathogens of them were Pseudomonas aeruginosa (15.6%). The rate of the ESBLs-producing strains of Escherichia coli and Klebsiella pneumoniae were 41.0% and 35.8%, respectively. Fungi were 44.1%. And all the fungi were sentive to amphotericin B, fluconazole and ketoconazole. Gram-postive cocci accounted for 8.6%. The most common pathogen of Gram-postive cocci was Staphylococcus. Meticillin resistant strains of Staphylococcus aureus accounted for 62.4%. CONCLUSIONS The drug-resistance of pathogenic bacteria due to nosocomial infection and community-acquired infection in respiratory medical ward is increasing year-by-year. It is necessary to continuously monitor drug-resistance and rationally use antibiotics.