医院下呼吸道感染的病原菌分布及耐药性分析

目的分析下呼吸道感染的病原菌分布及耐药状况,以指导临床合理选用抗生素。方法回顾性调查分析3 298例下呼吸道感染患者痰培养及药敏结果。结果 3 298例下呼吸道感染者,痰培养共检出菌株4 368株,以革兰阴性杆菌为主(71.0%),其次为革兰阳性球菌(17.2%)和真菌(11.8%)。革兰阴性杆菌以铜绿假单胞菌最多,其次为肺炎克雷伯菌;革兰阳性球菌主要是金黄色葡萄球菌;真菌以白色假丝酵母菌为主。药敏试验显示,革兰阴性杆菌对亚胺培南、美罗培南最敏感;革兰阳性球菌对万古霉素最为敏感;真菌对5-氟胞嘧啶和两性霉素B较敏感。结论革兰阴性杆菌是下呼吸道感染的主要病原菌,且细菌耐药性严重,应当引起足够重视。

Analysis on Distribution and Antibiotic Resistance of Pathogens Isolated from Nosocomial Lower Respiratory Tract Infection

Objective To analyze the distribution and drug resistance of pathogenic bacteria in patients with lower respira- tory tract infections so as to rationally select antibiotics for clinical treatment. Methods The results of bacterial cultures of sputum samples and drug sensitivity tests of 3,298 patients with lower respiratory tract infections were retrospectively analyzed, Results Totally 4,368 strains of pathogens were isolated from 3,298 patients with lower respiratory tract infections. Gram - negative bacteria were the dominant pathogens （71.0%）, followed by Gram-positive cocci （17.2%） and fungi （11.8%）. Of the Gram-negative bacteria, Pseudomonas aeruginosa was the most common pathogen, followed by Klebsiella pneumoniae. Staphylococcus aureuss was the main coccus among the Grampositive cocci, and Candida albicans was the dominant fungi. The results of drug susceptibility testing showed that the sensitivity of Gram- negative bacteria to mipenem and meropenem was the best, the sensitivity of Gram-positive cocci to vancomycin was the best, and the sensitivity of fungi to 5 - Fluoroeytosine and amphotericin B was better. Conclusions Gramnegative bacteria are the dominant pathogens in patients with lower respiratory tract infections, and the antibiotic resistance is serious. It is necessary to pay sufficient attention to this status.