下呼吸道感染患者病原菌分布及耐药性变迁

目的了解下呼吸道感染病原菌的分布及耐药性的变化趋势。方法统计2010年医院呼吸内科住院患者痰液培养标本及药敏结果,并与2005年结果比较。结果 2005年,2010年革兰阴性菌分别占当年总菌株数的64.7%和46.7%,革兰阳性菌分别占18.9%和22.2%,真菌分别占16.4%和23.6%。革兰阴性菌以铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌和不动杆菌为主,铜绿假单胞菌对亚胺培南耐药率有显著上升。革兰阳性菌以金黄色葡萄球菌和表皮葡萄球菌为主,两者对万古霉素敏感,对苯唑西林耐药,真菌以白色假丝酵母菌为主,对氟康唑耐药性增加。结论本组资料对下呼吸道感染的治疗和抗菌药物的选择有参考价值,应重视下呼吸道感染病原菌的变化及耐药性监测,抗菌药物的选择应在体外细菌药敏试验指导下进行。

Distribution and Drug Resistance to Changes of Pathogens among Patients with Lower Respiratory Tract Infection

Objective To investigate the distribution and the trend of drug resistance of pathogens isolated from inpatients with lower tract respiratory infection.Methods We analyzed the pathogens isolated from sputum of the hospitalized patients with lower respiratory tract infection in the department of respiratory medicine in 2010 and their drug resistance,and compare with results of 2005.Results In 2005 and 2010,gram-negative organisms accounted for 64.7% and 46.7% of that year,gram-positive organism 18.9% and 22.2%,fungi 16.4% and 23.6%.Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae Acinetobacter sp were the main strains in the isolated gram-negative.The resistance rates of Pseudomonas aeruginosa to imipenem mostly increased.Staphylococcus aureus and staphylococcus epidermidis were main strain in the isolated gram-positive.All of them were sensitive to vancomycin but resistant to oxacillin.Candida albicans were main strain in fungi.The resistance rates to Fluconazole were increased.Conclusions The data will be useful for choosing antimicrobial agents in the treatment of infections caused by pathogenic bacteria.It is important to observe the changes of pathogen and their resistance to antimicrobial agents.The use of antimicrobial agents should be guided by drug resistance test.