院内下呼吸道多重耐药菌感染病原学及耐药分析

目的了解院内下呼吸道多重耐药菌感染病原菌的分布特点及耐药情况,为临床治疗选择抗生素提供依据。方法对101例发生院内下呼吸道多重耐药菌感染患者的痰标本进行细菌培养分离及药敏试验。结果发生院内下呼吸道多重耐药菌感染的患者主要来自于重症监护室22.8%(23/101),神经外科16.8%(17/101),呼吸内科13.9%(14/101),菌株分离率排前四位的分别是鲍曼不动杆菌25.4%(35株)、肺炎克雷伯菌13.8%(19株)、金黄色葡萄球菌12.3%(17株)、铜绿假单胞菌8.7%(12株)。院内下呼吸道多重耐药菌感染的病原菌对头孢哌酮/舒巴坦、亚胺培南、万古霉素保持较好敏感性外,对其他抗生素均严重耐药。结论院内下呼吸道多重耐药菌感染病原菌以革兰阴性菌为主,细菌耐药率普遍较高,临床医师应重视病原学检查及药敏监测,合理选择及使用抗生素。

Analysis on the distribution and drug resistance of multidrug resistant bacteria in patients with nosocomial infection in lower respiratory tract

Objective To investigate the distribution and drug resistance of multidrug resistant bacteria in patients with nosocomial infection in lower respiratory tract for clinical treatment of selection of antibiotics.Methods The results of sputum’s culture and antimicrobial susceptibility of patients with nosocomial infection in lower respiratory tract from June 2009 to June 2010 were reviewed.Results The patients with nosocomial infection in lower respiratory tract were mainly from the intensive care unit 22.8%(23/101),neurosurgery 16.8%(17/101),respiratory medicine 13.9%(14/101).The top four multidrug resistant bacteria isolated were Acinetobacter baumannii 25.4%,Klebsiella pneumoniae 13.8%,Staphylococcus aureus 12.3%,and Pseudomonas aeruginosa 8.7%.The multidrug resistant bacteria in patients with nosocomial infection in lower respiratory tract were resistant to all antibiotics except cefoperazone-sulbactam,imipenem and vancomycin.Conclusion The multidrug resistant bacteria in patients with nosocomial infection in lower respiratory tract were mainly gram-negative bacteria,and bacterial resistance rates were relatively high.Clinicians should pay attention to etiology inspection and monitoring of drug sensitivity to select and use the antibiotics more reasonably.