下呼吸道感染病原菌分布及耐药性分析

目的探讨下呼吸道感染病原菌分布及耐药状况，为治疗下呼吸道感染疾病提供可靠依据，指导临床合理用药。方法对下呼吸道感染患者痰培养分离出的1203株病原菌及药敏试验结果进行回顾性分析。结果下呼吸道感染病原菌中铜绿假单胞菌检出率最高，为301株（25．0％）；其次为肺炎克雷伯菌268株（22．3％）、鲍曼不动杆菌186株（15．5％）、大肠埃希菌116株（9．6％）、金黄色葡萄球菌111株（9．2％）；对亚胺培南的耐药率：大肠埃希菌最低为0、肺炎克雷伯菌为0．9％。铜绿假单胞菌和鲍曼不动杆菌的耐药率较高，未发现耐万古霉素金黄色葡萄球菌。结论下呼吸道感染主要病原菌为铜绿假单胞菌和肺炎克雷伯菌，对头孢类和喹诺酮类药物的耐药率明显较高，临床应依据药敏报告结果合理选用抗菌药物。

Pathogens in lower respiratory tract infection: the distribution and drug resistance analysis

Objective To explore the distribution of lower respiratory tract infection pathogens and drug re-sistance status for the treatment of lower respiratory tract infection, to provide reliable evidence for clinical use of drugs. Methods The lower respiratory infection in patients with isolated sputum culture and sensitivity test of 1203 pathogens were retrospectively analyzed. Results Lower respiratory tract infections of Pseudomonas aeruginosa iso-lated in the highest detection rate, for 301 (25% ). Klebsiella pneumoniae was 268(22. 3% ) ; Acinetobacter bau-mannii was 186(15. 5% ); Escherichia coli was116(9.6% ) and Staphylococcus aureus was 111(9.2% ). The imi-penem resistance rate was 0.9% in Klebsiella pneumoniae and the lowest resistance rate was 0 in Escherichia coli.The high resistance rates were found in Pseudomonas aeruginosa and Acinetobacter baumannii. while no resistance was detected among vancomycin Staphylococcus aureus. Conclusion The main pathogens of lower respiratory tract infections are Pseudomonas aeruginosa and Klebsiella pneumoniae which show highe rates of drug resistance to ceph-alosporins and quinolones significantly. Clinical drug sensitivity results of the report should be based on reasonable selection of antimicrobial agents.