下呼吸道感染病原菌分布和耐药性分析

摘要

Objective To investigate the distribution and antibiotic resistance of pathogens in the patients with lower respiratory infections in our hospital. Methods Bacterial culture was preformed from sputum specimens of diagnosed patients with lower respiratory infections in our hospital. Bacterium's appraisal and antimi-crobial susceptibility test for positive specimens were preformed by the Microscan A/S-4 semi-automatic bacteria of America's spirit company and drug susceptibility analyzer and its supporting identification and drug susceptibility plate. Results Gram-negative bacilli were the major microorganism in bacterium. The top 5 pathogens are Pseudomo-nas aeruginosa, pneumonia crayresearch bacteria, baumanii/haemolyticus, Xanthomonas maltophilia and Escheri-chia coli. Drug sensitive experiments showed the resistance rate of gram-negative bacteria to broad-spectrum antibi-otics was increased. Drug resistance rate of pseudomonas aeruginosa against Ceftriaxine, pneumonia crayresearch bacteria and colon bacillus against penicillins and cephalosporin and Ammonia Qu Na was above 60%, 80% and 50% respectively. The resistant rate of Baoman/hematolysis bacillus to the majority antibiotics is above 70%, which of Xanthomonas maltophilia to cephalosporins, quinolones and aminoglycosides were above 90%. Coagulase-negative staphylococcus as the core of Gram-positive bacteria, the resistant rate to Penicillin and cephalosporin are above 85%. The resistance rate of staphylococcus to the majority antibiotics was comparatively low. Conclusions More attention should be paid on distribution and diversify of bacterium in lower respiratory infections clinically and rational use of antibiotics.%目的 了解我院下呼吸道感染患者病原菌分布及抗生素耐药情况.方法 对我院2006至2008年住院及门诊确诊的下呼吸道感染患者的痰液标本进行细菌培养,并采用美国德灵公司MicroscanA/S-4半自动细菌鉴定及药敏分析仪以及其配套的鉴定和药敏板对阳性标本进行细菌鉴定和药敏试验,并对试验结果进行分析.结果 细菌分布以革兰阴性杆菌为主,前5位的致病菌为铜绿假单胞菌、肺炎克雷伯氏菌、鲍曼/溶血不动杆菌、嗜麦芽黄单胞菌、大肠埃希氏菌.药物敏感试验显示,大多数革兰阴性菌对广谱抗生素的耐药率升高.铜绿假单胞菌对菌必治、头孢噻肟耐药率均在60%以上;肺炎克雷伯氏菌及大肠埃希氏菌对青霉素类的耐药率在80%以上,对头孢菌素类及氨曲南的耐药率在50%左右;鲍曼/溶血不动杆菌对大多数抗生素的耐药率在70%以上;嗜麦芽黄单胞菌对头孢菌素类、喹诺酮类及氨基糖苷类的耐药率在90%以上.革兰阳性菌以凝固酶阴性的葡萄球菌为主,其对青霉素类、头孢菌素类的耐药率在85%以上,金黄色葡萄球菌对大多数抗生素的耐药率较低.结论 临床上应重视细菌性下呼吸道感染的细菌分布及对药物的耐药率变迁,合理使用抗生素.