呼吸科和ICU下呼吸道感染痰标本细菌分类及耐药性分析

目的:通过对我院呼吸科及ICU符合下呼吸道感染的住院患者痰标本所培养的细菌分类及对抗菌药物耐药情况进行调查,为临床治疗感染性疾病选择抗菌药物提供参考意见。方法:回顾性分析2008年10月至2009年9月在我院呼吸科及ICU收治住院的下呼吸道感染患者培养出的307株细菌及其耐药性,采用SPSS 17.0软件对数据进行分析。结果:革兰氏阴性杆菌是主要致病菌,其中鲍曼不动杆菌(25.4%,78/307)位居第一,其次是铜绿假单胞菌(19.5%,60/307)、克雷伯杆菌(12.4%,38/307)。革兰阳性球菌中以耐甲氧西林金葡萄球菌为主(7.2%,22/307)。分离出的G-杆菌敏感的抗菌药物有亚胺培南/西司他丁钠(泰能)、头孢哌酮/舒巴坦、左氧氟沙星等;G+球菌尤其是耐甲氧西林金葡菌对阿奇霉素、克拉霉素、青霉素、氧氟沙星等耐药,但对万古霉素、利奈唑胺敏感。结论:革兰氏阴性杆菌是主要致病菌,耐药率高,尤其在呼吸及相关性肺炎患者更为突出,应积极预防。

Bacteriium features and the drug resistance in lower respiratory tract infection patientsin respiratory and ICU departments

Objective:To evaluate the pathogens spectrum and drug-resistance rates of bacteria isolated from lower respiratory tract infection patients in respiratory and ICU departments.Methods:Clinical data of 307 bacterial strain with lower respiratory tract infection from October 2008 to September 2009 were reviewed.The pathogen types and antibiotic sensitivity of pathogens isolated from cultured sputum collected from the patients were analyzed.Make vital statistics by SPSS 17.0 software.Results:Gram-negative bacteria was a major pathogen,Acinetobacter baumannii ranked first(25.4%,78/307),followed by Pseudomonas aeruginosa(19.5%,60/307),k.pneurnoniae(12.4%,38/307),Methicillin-resistant Staphylococcus aureus is the main croorganism in Grampositive cocci(7.2%,22/307).The effective agents against Gram-negative bacteria were Imi-penem/Cilastati,Cefoperazone/sulbactam,levofloxacin etc.;Grampositive cocci,especially the Methicillin-resistant Staphylococcus aureus were against Azithromycin,clarithromycin,Penicillin,Ofloxacin,but it was sensitive to Vancomycins,Linezolids.Conclusion:Gram-negative bacteria are the main pathogen in pneumonia.the rate of drug-resisted is high,especially in ventilator-associated-pneumonia,we should take appropriate measures to actively prevent.