328株下呼吸道感染病原菌分布与药敏分析

目的:分析院内下呼吸道感染常见病原菌种类与分布,并对其药敏结果进行分析,为临床合理使用抗菌药物提供参考。方法:参照美国临床实验室标准化委员会(CLSI)2006年推荐方法操作,统一采用CLSI2006年标准判断药物敏感度,采用美国Microscan A/S-4半自动细菌鉴定及药敏分析仪,对2008年1月-2009年12月间下呼吸道感染患者的痰液标本中分离出的328株致病菌的药敏试验进行分析。结果:痰标本中分离出的328株病原菌中,革兰阴性菌217株(66.16%),主要以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼/溶血不动杆菌为主;革兰阳性菌100株(30.49%),主要以金黄色葡萄球菌、溶血葡萄球菌、表皮葡萄球菌为主;其他病原菌11株(3.35%)。革兰阴性菌抗菌药物耐药率分别为氨苄西林(83.20%)、环丙沙星(53.44%)、氨曲南(51.24%);革兰阳性菌抗菌药物耐药率分别为青霉素(88.02%)与替卡西林(65.15%)。结论:下呼吸道感染患者以革兰阴性菌感染为主(66.19%),耐药率较高的为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌,临床应重视院内下呼吸道细菌性感染的细菌分布及细菌对药物的耐药率,合理选用抗菌药物。

Distribution and Analysis of Drug Sensitivity of 328 Strains infected in Lower Respiratory Tract

Objective： To analyze the species and distribution of common pathogens in lower respiratory tract infection in hospitals,and to analyze the drug sensitivity results.It provides a clinical reference for the rational use of antimicrobial agents.Methods： The method recommended by Committee for Clinical Laboratory Standards （CLSI） in 2006 was referred to operate.The standard of CLSI in 2006 was used to determine the drug sensitivity,and the US Microscan A/S-4 semi-automatic bacterial identification and susceptibility analyzers were used.The drug sensitivity tests of 328 pathogenic bacteria isolated from the sputum samples in patients with lower respiratory tract infection on January 2008-December 2009 were analyzed.Results： In 328 pathogens isolated from the sputum samples,there were 217 strains gram-negative bacteria（66.19%） based mainly on Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Bowman/Hemolytic Acinetobacter;There were 100 strains gram-positive bacteria（30.49%）based mainly on Staphylococcus aureus,Staphylococcus haemolyticus and Staphylococcus epidermidis;There were 11 strains other pathogens （3.35%）.In gram-negative bacteria,the highest rate of antibiotic resistance was ampicillin（83.20%）,ciprofloxacin（53.44%）and aztreonam（51.24%）;In gram-positive bacteria,the highest rate of antibiotic resistance was penicillin（88.02%） and ticarcillin（65.15%）.Conclusion： The patients with lower respiratory tract infection based mainly on gram-negative bacteria infection（66.19%）.The higher resistance pathogens were Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa.The clinicians should pay attention to the bacterial distribution and the rate of drug resistance in patients with lower respiratory tract bacterial infection.So that the antimicrobial drugs were used rationally.