院内呼吸科下呼吸道感染病原学及耐药性结果分析

目的分析大连市第五人民医院2009年呼吸科送检1160例次痰标本细菌检查情况,为临床提供感染数据以及合理使用抗生素提供依据。方法按常规方法将临床送检的痰标本进行细菌培养、分离。使用BIO-FOSUN微生物鉴定药敏分析系统进行细菌鉴定及抗生素敏感试验。结果一年来共收痰标本1160例次,检出病原菌253例次,阳性率为21.8%。病原菌依次为肺炎克雷伯菌83株,铜绿假单胞菌57株,乙酸钙不动杆菌29株,阴沟肠杆菌14株,粘质沙雷菌13株,大肠埃希菌10株,,金黄色葡萄球菌5株等。大多数革兰阴性菌对亚胺培南较敏感,对头孢菌素类均有不同程度的耐药。革兰阳性球菌对万古霉素敏感,对其他抗生素有不同程度的耐药。结论该院呼吸科患者下呼吸道感染以革兰阴性杆菌为主,常见病原菌耐药性未呈现高水平、多重耐药情况。提示临床医生应与检验科密切配合,关注细菌感染情况,根据药敏试验结果合理选用抗生素。

Nosetiological analysis of drug resistance in lower respiratory tract infection

Objective To understand the dist ribution and drug resistance of pathogenic bacteria in lower respiratory tract infection in our hospital and provide the basis for rational use of drugs.Method The bacteria identification system of France biomerieux BIOFOSUN was used for bacterial identification. Drug sensitivity test was performed with paper stip method.Result 253 strains of pathogenic bacteria were separated from the sputum sample of 1 160 cases,which including Klebsiella pneumoniae（83）,Pseudomonas aeruginosa（57）,Acinetobacter（29）,Enterobacter cloacae（14）,Serratia marcescens（13）,Escherichia coli（10） and Staphylococcus aureus（5）. The drug resistance rate of gram negative bacilli was the highest to sulfame. Conclusion The lower respiratory t ract in fections are mainly caused by gram negative bacilli. Clinicians must use antibiotics reasonably depending on the resultsof drug sensitivity tests.