2007年至2009年下呼吸道感染的病原菌分布及耐药性变迁

目的：探讨下呼吸道感染的病原菌分布及耐药情况。为临床合理使用抗生素提供依据。方法：对医院2007年1月至2009年12月间住院的下呼吸道感染患者痰培养分离出的2401株病原菌进行鉴定和耐药分析。结果：2401株菌中革兰氏阴性杆菌1533株,占63.85%,主要为铜绿假单胞菌（15.73%）、肺炎克雷伯菌（12.47%）、鲍曼不动杆菌（12.05%）、大肠埃希菌（7.11%）;真菌531株。占22.12%,主要为白假丝酵母菌;革兰氏阳性球菌337株,占14.04%,主要以金黄色葡萄球菌为主。革兰氏阴性杆菌对碳青霉烯类抗生素的敏感率最高,但对其它抗菌药的敏感率下降趋势明显;革兰氏阳性球菌对万古霉素仍能保持较高的敏感率（100%）,但对其它抗菌药的耐药情况严重。结论：下呼吸道常见细菌对常用的抗生素耐药率较高,临床应严格遵守抗生素使用原则,合理应用抗生素。

Bacterial Distribution and Drug Resistance Analysis in Lower Respiratory Tract Infection Between 2007 -2009

Objective：To study the distribution and resistance of pathogens in patients with lower respiratory tract infection between 2007-2009,and propose rational use of antibiotics in clinic practice.Method：The pathogens from the lower respiratory tract specimens were isolated and cultured from the patients in hospital from 2007 to 2009.The total 2401 strains of pathogens were indentified and the drug resistance was analyzed.Result：In the 2401 strains,there were 1533 strains of gram negative bacterium which accounted for 63.85%,mainly included pseudomonas aeruginosa（for 15.73%）、klebsiella pneumonia（for 12.47%）、acinetobacter baumannii（for 12.05%）and escherichia coli（for 7.11%）;531 strains of fungus（for 22.12%）,mainly is candida albicans（for 17.33%）;337 strains of gram-positive cocci（for 14.04%）,mainly is staphylococcus aureus;carbapenems was the most active antibiotics for gram negative bacilli,and vancomycin for gram positive cocci.Pathogens antibiotics rate sensitive sustained downward trend.Conclusion：The resistance rate of common bacteria on common antibiotics is high.We should abide strictly by the rules of antibiotics using and use antibiotics rationally.