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目的分析下呼吸道感染患者病原菌分布及耐药性,指导临床合理用药。方法收集我院2013年至2015年院内感染患者痰标本进行细菌培养和药物敏感性试验。结果 3年共收集下呼吸道痰液标本21 615份,分离病原菌5 621株,阳性率为26.0%;其中革兰阴性(G~-)菌4 249株,占75.6%,以铜绿假单胞菌居多(20.7%);真菌764株,占13.6%,以白假丝酵母居多(12.6%);革兰阳性(G~+)菌608株,占10.8%,以金黄色葡萄球菌居多(9.9%)。药物敏感试验结果显示:G~-杆菌对亚胺培南、美洛培南耐药率最低,对青霉素类、喹诺酮类和部分三代头孢类等抗菌药耐药率较高(>50.0%)。G~+球菌对万古霉素、利奈唑胺耐药率为零,对青霉素类、喹诺酮类和红霉素等抗菌药耐药率较高(>40.0%)。结论下呼吸道感染患者病原菌以G~-杆菌为主,耐药性呈增长趋势,临床应加大病原菌分布检测及其耐药性监测力度,及时调整抗菌药物用药。
Objective To analyze the distribution and drug resistance of pathogenic bacteria in patients with lower respiratory tract infection and to guide rational drug use in clinical practice. Methods The sputum samples from patients with nosocomial infection from 2013 to 2015 in our hospital were collected for bacterial culture and drug susceptibility testing. Results A total of 21 615 specimens of sputum from lower respiratory tract were collected in 3 years. A total of 5 621 strains of pathogens were isolated, the positive rate was 26.0%. 4 249 strains (75.6%) of Gram-negative bacteria (G ~ -) (10.7%), mostly Staphylococcus aureus (9.9%), Staphylococcus aureus (9.9%), Staphylococcus aureus ). The results of drug susceptibility test showed that the drug resistance rates of imipenem and meropenem to G ~ - bacilli were the lowest, and the antibiotic resistance rates to penicillins, quinolones and some third generation cephalosporins were higher (> 50.0%). The resistant rate of vancomycin and linezolid to G ~ + cocci was zero, and the antibacterial rate to penicillins, quinolones and erythromycin was higher (> 40.0%). Conclusions The pathogenic bacteria of lower respiratory tract infection mainly consist of G - bacilli, and the drug resistance tends to increase. Clinically, the distribution of pathogenic bacteria should be increased and the drug resistance monitoring should be strengthened to adjust the antibacterial drugs timely.