呼吸道感染病原菌分布及耐药分析

目的了解呼吸道感染致病茵茵谱及耐药性。方法对诊断为下呼吸道感染的住院患者合格211份痰标本进行细菌学检查，阳性茵采用法国梅里埃生物公司细菌鉴定条鉴定。采用K-B纸片扩散法进行药敏试验。结果211份痰标本分离出致病菌216株，以G^-茵为主，占43．5％，G^ 茵占27．3％；表皮葡萄球菌、铜绿假单胞茵、其他假单胞茵、流感嗜血杆菌和肺炎克雷伯杆菌。占分离茵前5位，分别为13．8％、8．3％、8．8％、5．1％、5．1％。药敏结果提示D群链球菌、肠球菌、其他假单胞茵、肺炎克雷伯和鲍曼不动杆茵对多种抗生素呈现高比例耐药。铜绿假单胞茵对三代头胞、喹诺酮及氨基甙类仍敏感。万古霉素对G^ 茵高度敏感。结论呼吸道感染以G^-茵为主，其比例较以往报道下降，耐药率较高，且多重耐药。临床宜根据药敏结果选择抗生素并合理使用。

Bacterial spectrum and drug resistance of respiratory tract infections

Objective To realize the bacterial spectrum and drug resistance of respiratory tract infections Methods Qualified sputum specimens from inpatients with respiratory tract infections between Jan. 2002 and Jan. 2004 were. cultured for bacterial isolation, and drug sensitivity tests were detected by the K-B method Results Two hundred and sixteen strains were isolated from 211 sputum specimens, 43 5% of which were Gram negative bacilli, 27 3% Gram positive bacilli, and 29 15% Fungus The 5 most common isolated bacteria were Staphylococcus epidermis, Pseudomonas aerations, Acinetobacter, Haemophilus influenzae, and other Pseudomonas, with the isolating rates of 13 8%, 8 3%, 5 1%, 5 1%, and 8 8%, respectively Gram positive bacilli were sensitive to vancomycin Pseudomonas aeruginosa was relatively sensitive to Ceftazidme, Ciprofloxacin, and Amikacin The other isolated strains showed resistance to all the agents tested at varying levels Conclusion Gram negative bacilli have become the major pathogens in respiratory tract infections with high drug resistance, but the infected proportion by Gram negative bacilli have decreased and fungal infection rate increased as compared with previous reports Selection of sensitive antibiotics should base on drug sensitivity tests