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院外获得性呼吸道感染或社区获得性呼吸道感染、是指在门诊就医的急性上、下呼吸道感染.治疗这类感染.以往有效的口服抗生素.如今疗效越来越不能令人满意、本文就院外获得住呼吸道感染病原菌耐药性、菌种变迁及新一代口服抗生素综述如下.1 院外获得性呼吸道感染病原菌的耐药性及菌种变迁近年来研究发现院外获得性呼吸道感染的常见致病菌对传统口服抗生素的耐药现象越来越明显.例如约4～5%的肺炎链球菌对氨苄青霉素耐药,约30～40%的化脓性链球菌感染的病人用青霉素治疗失败.流感嗜血杆菌产酶菌株从1981年的17%、增加到199年的60%.可是院外获得性肺炎中、肺炎链球菌占44.9%,流感嗜血杆菌占14.3%,两者约占院外获得性肺炎病原菌的60%,是主要致病菌.但它们的耐药性菌株日渐增多.细菌耐药性分为天然和突变产生的耐药性.前者为染色体基因介导.后者为质粒介导.细菌通过耐药因子产生酶,如β-内酞胺酶,使抗生素在作用于菌体前就被破坏或失效.
Out-of-hospital acquired respiratory infections or community-acquired respiratory infections refer to acute upper and lower respiratory tract infections that seek medical attention in outpatient settings and have been used as effective oral antibiotics in the past. Resistant to respiratory tract infections pathogens, changes in species and a new generation of oral antibiotics are summarized as follows.1 Out-of-hospital acquired respiratory tract infections pathogenic bacteria resistance and species changes in recent years found that common outside-hospital acquired respiratory tract infections of traditional pathogens For example, about 4 to 5% of Streptococcus pneumoniae is resistant to ampicillin and about 30 to 40% of patients with Streptococcus pyogenes infection fail to be treated with penicillin. Haemophilus influenzae production Enzyme strains increased from 17% in 1981 to 60% in 1991. However, out of hospital-acquired pneumonia, Streptococcus pneumoniae accounted for 44.9% and Haemophilus influenzae 14.3%, both of which accounted for 60% of hospital-acquired pneumonia pathogens %, Is the main pathogenic bacteria, but their resistance strains are increasing. Bacterial resistance is divided into natural and mutation-resistant, the former mediated by the chromosomal gene. Bacterial enzymes produced by plasmid-mediated resistance factors, such as the β- Thalidomide enzyme to act on antibiotics bacteria are destroyed before or failure.