下呼吸道感染革兰阴性杆菌的分布特征及耐药性分析

目的研究下呼吸道感染革兰阴性杆菌的分布特征并对其药敏结果进行分析,为临床合理使用抗生素提供依据。方法对泗县中医院感染科2009年1月至2010年12月670例下呼吸道感染患者的痰标本进行常规细菌培养,利用VITEK-32型全自动微生物鉴定及药敏分析仪对培养出的纯菌株进行鉴定和药敏试验。结果 388株病原菌中革兰阴性杆菌276株,占71.1%,前5位分别是肺炎克雷伯菌肺炎亚种占31.2%,大肠埃希氏菌占15.6%,阴沟肠杆菌占12.7%,铜绿假单胞菌占10.9%,鲍曼不动杆菌占6.5%;药敏结果显示,美罗培南、亚胺培南耐药率很低,氨苄西林、哌拉西林、头孢唑啉、头孢呋辛钠、头孢呋辛酯耐药率很高。结论 下呼吸道感染病原体以革兰阴性杆菌为主。革兰阴性杆菌不同菌种对同一抗菌药物敏感差异较大,应根据药敏结果选择抗生素以减少耐药菌株的产生。

Analysis of the distribution and drug-resistance of Gram-negative bacilli in lower respiratory tract infection

Objective To investigate the distribution of Gram-negative bacilli isolated from patients with lower respiratory tract infection and analyze their drug sensitivity in order to provide reference for rational use of antibiotics.Methods A total of 670 sputum samples collected from patients with lower repiratory tract infection in our hospital from January 2009 to December 2010 were identified and the drug sensitivity tests were performed using VITEK-32 Compact System.Results Of 388 bacteria isolates,276 were Gram-negative bacilli（71.1%）.The main Gram-negative bacilli were Klebsiella pneumoniae（31.2%）,Escherichia coli（15.6%）,Enterobacter cloacae（12.7%）,Pseudomonas aeruginosa（10.9%）,and Acinetobacter baumannii（6.5%）.The resistance rates of Gram-negative bailli to meropenem,imipenem were relatively low.The resistance rates of Gram-negative bailli to ampicillin,piperacillin,cefazolin,cefuroxime-sodium and cefuroxime axetil were very high.Conclusion Lower respiratory tract infection pathogens were gram-negative bacilli.For the same antimicrobial agent,different bacteria show different sensitivities.Antibiotics should be selected according to the results of drug sensitivity test to reduce the production of drug-resistant strain.