济宁市某医院呼吸道感染患者病原菌分布及耐药性分析

目的了解济宁市第一人民医院呼吸道感染的病原菌菌群分布及耐药性，为临床治疗提供依据。方法采取生物梅里埃APISystem鉴定和VitekAmSystena微生物自动分析仪进行细菌鉴定，抗生素耐药性分析采用K—B纸片法，20eAUX酵母菌法测定真菌。MIC评价其耐药性。结果从148例呼吸道感染患者留取的痰标本中共分离出菌株120株，病原菌以革兰阴性菌为主，占66．7％，前5位分别为铜绿假单胞、肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌及阴沟肠杆菌和嗜麦芽寡养单胞菌；革兰阳性菌占23．3％，主要为金黄色葡萄球菌、肺炎链球菌及粪肠球菌和肺炎链球菌；真菌占10．0％，以白念珠菌为主。大多数革兰阴性菌对头孢哌酮／舒巴坦、左氧氟沙星、亚胺培南的耐药率较低，耐药率为5．8％～33．3％；头孢唑林、头孢曲松、氨苄西林的耐药率较高，耐药率均在50％以上。革兰阳性致病菌对万古霉素较敏感，对其他抗菌药物耐药程度均较低。结论济宁市第一人民医院呼吸道感染的病原菌以革兰阴性杆菌为主，且耐药菌株所占比例较高，应合理地应用抗菌药物。

Distribution and Drug Resistance of Pathogenic Bacteria in Patients With Respiratory Tract Infection

Objective To understand the distribution and drug resistance of pathogenic bacteria in respiratory tract infections, and to provide a basis for clinical treatment. Methods BioMerieux API System and Vitek Am System were both adopted for bacteria identification. K - B test was employed for analyzing antibiotic re- sistance, 20eAUX for fungi detection and MIC for evaluation the resistance. Results A hundred and twenty strains collected from 148 patients were isolated and the Gram - negative bacteria accounted for 66.7% of the total strains. The top five bacteria were respectively pseudomonas aeruginosa, Klebsiella pneumoniae, Esch- erichia coli, acinetobacter bacteria and enterobacter cloacae. The Gram -positive bacteria accounted for 23.3% of the total strains, mainly staphylococeusaureus, streptococcus Pneumoniae conjugate, Enterococ- cus faecalis and streptococcus pneumonia. Fungi took a proportion of 10. 0% , mainly Candida albicans. The majority of gram - negative bacteria were sensitive to imipenem, penicillin, levofloxacin, with the drug resistance rates ranging from 5.8% to 33.3%, while the drug resistance rates of cefazolin, Ceftriaxone and ampicillin were all above 50%. The Gram - positive bacteria were sensitive to vancomycin but not so sensitive to other antibiotics. Conclusion The respiratory tract infection pathogens in Jining hospital are mainly Gram - negative bacilli with relatively high drug resistance rate. Thus, Reasonable application of antibacteri- al agents should be emphasized.