下呼吸道感染者检出病原菌的分布及耐药性分析

目的了解下呼吸道感染患者痰液中的主要病原菌及其耐药性,为临床医生抗感染治疗提供合理选用抗生素的信息。方法对2006年01月～2009月12月到我院住院的下呼吸道感染患者送检的合格痰液标本进行细菌学培养、鉴定及抗生素敏感试验,做统计分析。结果分离获得298株细菌,G~-杆菌占52.4%,其中以铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌占前3位;G~＋球菌占26.3%,其中以溶血葡萄球菌、金黄色葡萄球菌、粪肠球菌占前3位;真菌占18.3%,其中以白色念珠菌为主。药敏结果提示亚安培南对革兰阴性杆菌作用最强,革兰阳性球菌对万古酶素高度敏感,对其他抗菌药物存在不同程度的耐药。结论下呼吸道感染患者痰液中以革兰阴性杆菌占优势,白色念珠菌的感染率呈上升趋势,并出现多重耐药,临床医生应根据药敏结果合理选用抗生素治疗。

Flora distribution and drug-resistance analysis of pathogenic bacteria in patients with lower respiratory tract infection

Aim To survey the distribution and drug resistance of pathogens phlegm of lower respiratory tract infections.Methods The eligible phlegm specimens collected from lower respiratory tract infection patients in our hospital from January 2006 to December 2009 were examined by germiculture and identified and the antibiotic sensitive tests were also conducted.Results There 298 bacteria were isolated and the gram-negative bacilli were 52.4%and the first 3 were Pseudomonas aeruginosa、K.peumoniae and Escherichia coli;the gram-positive cocci were 26.3%and the first 3 were Staphylococcus haemolyticus,Staphylococcus aureus and Enterococcus faecalis.Fungi accounted for 18.3%and Candida albicans predominated.Gram-negative bacilli were the most sensitive to lmipenem,and gram-positive cocci were extremely sensitive to vancomycin,while they were resistant to other antibacterial drug in varying degrees.Conclusion The gramnegative bacilli were the major bacteria in phlegm of lower respiratory tract infection patients.The infection rate of Candida albicans was on the rise.Multiple antibiotic resistance was observed.