呼吸科住院患者痰液病原菌类型及耐药性变迁分析

目的了解2010～2011年医院呼吸科下呼吸道感染患者痰液病原菌类型及耐药性变迁情况。方法分离送检痰液病原菌,采用API系统鉴定菌种,纸片扩散法(K-B法)进行药物敏感试验,对常见病原菌耐药性变迁情况进行分析。结果 2010～2011年呼吸科送检痰标本1 560份,检出病原菌501株,检出率32.12%,其中革兰阳性菌184株,占36.72%,革兰阴性菌296株,占59.08%,真菌21株,占4.19%。分离菌株数居前4位病原菌分别为铜绿假单胞菌(98株)、肺炎克雷伯菌(81株)、金黄葡萄球菌(78株)和大肠埃希菌(61株)。革兰阴性菌对万古霉素、亚胺培南、苯唑西林、头孢哌酮/舒巴坦、氨曲南的耐药率较低;金黄葡萄球菌对亚胺培南、万古霉素、苯唑西林的耐药率为较低,对其他抗菌药物均呈现出较高的耐药性。病原菌的耐药率2011年高于2010年。结论呼吸科痰液分离病原菌以革兰阴性菌为主,分离菌对常见抗生素的耐药明显,且呈逐年升高趋势。

Distribution and changes in drug resistance of pathogens causing lower respiratory tract infections in Respiratory Medicine

Objectives To analyze the distribution and drug resistance of the pathogens causing lower respiratory tract infections in Respiratory Medicine and provide guidance and evidence for clinical treatment.Methods Pathogens in sputum were isolated,strains were identified with an API system,and a drug sensitivity test was performed using the disc diffusion method(K-B law).Changes in pathogen drug resistance were analyzed.Results In total,501 strains of pathogens were isolated from 1 560 sputum samples;of these,296 strains(59.08%) were Gram-negative bacteria,184(36.72%) were Gram-positive bacteria,and 21(4.19%) were fungi.The most predominant pathogen isolated was Pseudomonas aeruginosa,detected at a rate of 19.56%,followed by Klebsiella pneumoniae(16.17%),Staphylococcus aureus(15.57%),and Escherichia coli(12.18%).Gram-negative bacteria had less resistance to Vancomycin,Imipenem,Meropenem,and Oxacillin.There were more drug-resistant pathogens in 2011 than in 2010.Conclusion Acteria isolated in Respiratory Medicine were mainly Gram-negative bacteria.Drug resistance of major pathogens is a serious problem,so monitoring of drug resistance should be enhanced.