肠杆菌科细菌肺部感染病原菌分布与耐药性监测

目的了解浙江龙游县人民医院肠杆菌科细菌肺部感染病原菌分布及耐药性,为临床合理使用抗菌药物提供依据。方法采用纸片扩散法对病原菌进行药敏试验,并进行ESBLs检测,按CLSI 2012年标准判定药敏结果,用WHONET 5.6软件分析结果。结果痰培养共分离出371株肠杆科细菌,主要为肺炎克雷伯菌、大肠埃希菌和阴沟肠杆菌,产ESBLs菌阳性率高,对碳青霉烯类抗菌药物耐药率低,均在10.00%以下,其他药物均有不同程度耐药,测试抗菌药物的耐药率差异有统计学意义（P〈0.05）。结论临床常见肠杆菌科细菌耐药率高,开展病原菌耐药性监测,对指导临床抗感染治疗合理选择抗菌药物具有重要意义。

Distribution and drug resistance of pathogenic bacteria of Enterobacteriaceae lung infection

Objective To learn the pathogenic distribution and drug resistance of Enterobacteriaceae lung infection in Longyou People＇s Hospital, and provide basis for clinical rational use of antibiotics. Methods The disk diffusion method was used for drug sensitivity test of pathogenic bacteria ; ESBLs detection was performed ; The antimicrobial susceptibility results were evaluated according to CLSI 2012 standard and analyzed with WHONET 5.6 software. Results 371 strains of Enterobacteriaceae were isolated from sputum specimens, with K. pneumoniae, E. coli and E. cloacae being the main pathogens. The rate of ESBLs-producing bacteria was high. The resistance rates to carbapenems were under 10.00%. The pathogens were resistant to other drugs in various degrees. The differences of resistance rates were statistically significant （ P 〈 0.05 ）. Conclusion The resistance rates of clinically common Enterobacteriaceae are high. The monitoring of drug resistance is important for rational use of drugs in clinical anti-infection treatment.