下呼吸道感染的病原菌变迁及耐药状况分析

目的：了解近年来下呼吸道感染病原菌的变迁及耐药状况，为病原学调查及临床治疗提供依据。方法：用WHONET－4软件统计分析1998，1999及2000年本院所有门诊和住院病人的痰培养及药敏结果。结果：病原菌变迁方面，肺炎链球菌，大肠埃希氏菌，念珠菌等导致的下呼吸道感染日益增多，耐药性方面，葡萄球菌属细胞对苯唑西林，链球菌对青霉素类，肠杆菌科细菌对三代头孢，假单胞菌属细菌对哌拉西林等经验治疗中常用药物的敏感率呈逐年下降趋势；产超广谱β－内酰胺酶（ESBL）菌株，耐青霉素的肺炎链球菌（PRP）及耐甲氧西林的葡萄球菌（MRS）等特殊耐药菌在下呼吸道感染病原菌已占有相当比例。结论：及时了解下呼吸道细菌病原菌的变迁及耐药性的变化，加强对特殊耐药菌株的检测对下呼吸道感染的治疗提供依据。

Mobility of pathogenic bacteria and their drug resistance in lower respiratory tract infections

Objective To explore the changes of pathogenic bacteria mobility and their drug resistance characteristics in lower respiratory tract infections for further etiology investigation and clinical treatment. Methods The results of sputum culture and total susceptibility rate of the outpatients and inpatients with lower respiratory tract infections from Xinqiao Hospital during 1998 to 2000 were analyzed statistically with WHONET 4 software. Results The rates of lower respiratory tract infection caused by Streptococcus pneumoniae , E.coli and Candida were increased significantly. The susceptibility rates of Staphylococcus to Oxacillin, Streptococcus to Penicilin, Enterobacter to third generation Cephalosporins, and Pseudomonas to Piperacillin were decreased. Extended spectrum beta lactamase producing strains (ESBLs), methicillin resistant Staphylococcus (MRS) and Penicillin resistant Streptococcus pneumoniae (PRP) covered large proportions in pathogenic bacteria causing lower respiratory tract infection. Conclusion The results are helpful in pathogenic bacteria and their drug resistance characteristics in lower respiratory tract infection, and in the detection of these bacteria.