呼吸内科住院患者感染性标本留取时间与细菌耐药性的关系

目的 了解呼吸内科患者病原菌的分布及其对抗菌药物的耐药性与感染性标本留取时间的关系,为临床合理应用抗菌药物提供依据.方法 用ESP血培养仪及美国德灵公司Micro Scan Walk Away 40全自动微生物分析仪对送检血、痰、气管抽取物等标本进行培养、鉴定及药敏试验；计算留取标本时间与入院时间的间隔,分为≤2、3～14、≥15d组.结果 共收集感染性标本626株,其中革兰阴性菌520株占83.1％,革兰阳性菌106株占16.9％,铜绿假单胞菌分离最多占26.2％,其次为鲍氏不动杆菌占14.1％,革兰阳性菌中前2位为金黄色葡萄球菌占4.8％,表皮葡萄球菌占4.5％；铜绿假单胞菌、鲍氏不动杆菌、金黄色葡萄球菌等随住院时间延长,对大部分抗菌药物的耐药性增加.结论 随着治疗时间的延长,细菌耐药性迅速增加,积极控制感染,尽量缩短住院时间,可能延缓细菌耐药性的发生.

Relationship between bacterial resistance and retention of infectious specimens from hospitalized patients in department of respiratory medicine

OBJECTIVE To investigate the distribution of the pathogens isolated from the patients in department of respiratory medicine and study the relationship between drug resistance and the retention of infectious specimens.so as to provide basis for clinical reasonable use of antibiotics.METHODS The submitted blood,sputum,tracheal extracts and other specimens were cultured and identified with the ESP blood culture system and American Sterling Corporation Micro Scan Walk Away 40 automatic micro analyzer,the drug susceptibility testing was performed;the interval between the hospital admission and the retention of infectious specimens was calculated and divided into ≤ 2-day group,3-14 days group,and ≥15days group.RESULTS A total of 626 strains of bacteria were isolated,including 520 strains of gram-negative bacteria(83.1%) and 106 strains of gram-positive bacteria(16.9%),the isolation rate of Pseudomonas aeruginosa was the highest(26.2%),followed by Acinetobacter baumannii(14.1%);Staphylococcus aureus(4.8%) and S.epidermidis(4.5%) were the top 2 gram-positive bacteria;the resistance rates of P.aeruginosa,A.baumannii and S.aureus to most of antibiotics were increased with a prolonging hospital stay.CONCLUSION The bacterial resistance is increased with the extension of hospital stay.To actively control the infection and shorten the hospital stay may delay the bacterial resistance.