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目的探讨下呼吸道感染患者支气管镜肺泡灌洗病原菌的种类及其对抗生素的敏感性情况。方法针对2011年1月-2012年8月经支气管镜肺泡灌洗培养阳性病例50例,经鉴定对其分类,并实施纸片扩散法进行丁氨卡那、亚胺培南、氨苄西林、庆大霉素、环丙沙星、头孢哌酮、头孢噻肟、左氟沙星、氨曲南、头孢他啶等10种抗菌药物的药敏试验,调查其耐药性情况。结果本组经API鉴定分离出铜绿假单胞菌23例、大肠埃希菌6例、鲍氏不动杆菌7株及肺炎克雷伯菌7株;嗜麦芽窄食单胞菌4例;真菌3例;耐药性检查结果示除嗜麦芽窄食单胞菌对亚胺培南耐药率75%以外,铜绿假单胞菌对亚胺培南耐药率为8.6%以外,其余大肠埃希菌、鲍氏不动杆菌及肺炎克雷伯菌对亚胺培南的耐药率均为0%。而各类菌属对亚胺培南以外的抗生素均有一定耐药性,其程度不一,尤其鲍氏不动杆菌对亚胺培南以外的其它抗生素的耐药率均高达100%。结论下呼吸道感染主要致病菌为铜绿假单胞菌,亚胺培南是治疗该病的比较有效的抗生素。
Objective To investigate the types of bronchoalveolar lavage pathogens and their sensitivity to antibiotics in patients with lower respiratory tract infections. Methods From January 2011 to August 2012, 50 cases of positive bronchoalveolar lavage culture were identified, classified according to the classification, and implemented the diffusion method of amoxicillin, imipenem, ampicillin, Qingda Drug susceptibility test of 10 antibacterials including ciclosporin, ciprofloxacin, cefoperazone, cefotaxime, levofloxacin, aztreonam and ceftazidime was conducted to investigate the drug resistance. Results In this study, 23 strains of Pseudomonas aeruginosa, 6 strains of Escherichia coli, 7 strains of Acinetobacter baumannii, 7 strains of Klebsiella pneumoniae, 4 strains of Stenotrophomonas maltophilia, 3 cases; drug resistance test results showed that in addition to Stenotrophomonas maltophilia resistant to imipenem 75%, Pseudomonas aeruginosa imipenem resistance rate was 8.6%, the other large intestine Mycobacterium, Acinetobacter baumannii and Klebsiella pneumoniae resistant to imipenem were 0%. All kinds of bacteria are resistant to antibiotics other than imipenem to varying degrees. In particular, Acinetobacter baumannii resistance rates to other antibiotics other than imipenem are as high as 100%. Conclusion The main pathogen of lower respiratory tract infection is Pseudomonas aeruginosa, imipenem is a more effective antibiotic for the treatment of the disease.