【摘要】：目的探討下呼吸道感染患者的病原菌分布及耐藥性,為臨床合理選擇抗菌藥物提供依據(jù)。方法對(duì)某院2013年1月1日—2014年12月31日送檢的肺泡灌洗液標(biāo)本進(jìn)行培養(yǎng),采用紙片擴(kuò)散法對(duì)陽性標(biāo)本菌株進(jìn)行藥敏試驗(yàn)。結(jié)果 7 702份肺泡灌洗液標(biāo)本共分離菌株999株,其中細(xì)菌、真菌和分枝桿菌分別為398株(5.17%)、326株(4.23%)和275株(3.57%)。細(xì)菌主要包括銅綠假單胞菌(97株)、鮑曼不動(dòng)桿菌(87株)、肺炎克雷伯菌(62株)、金黃色葡萄球菌(44株)、流感嗜血桿菌(28株);真菌主要包括白假絲酵母菌(161株)、煙曲霉菌(41株)、黃曲霉菌(38株);分枝桿菌主要包括結(jié)核分枝桿菌(271株)。藥敏結(jié)果顯示銅綠假單胞菌對(duì)常用抗菌藥物(除替卡西林/克拉維酸和左氧氟沙星外)的耐藥率均30.00%。鮑曼不動(dòng)桿菌對(duì)氨芐西林/舒巴坦、亞胺培南、阿米卡星、慶大霉素和妥布霉素的耐藥率均80.00%,對(duì)其他常用抗菌藥物的耐藥率介于36.84%~60.53%。62株肺炎克雷伯菌中產(chǎn)超廣譜β-內(nèi)酰胺酶(ESBLs)有20株。產(chǎn)ESBLs株的耐藥率明顯高于非產(chǎn)ESBLs株。44株金黃色葡萄球菌中26株為耐甲氧西林金黃色葡萄球菌(MRSA),金黃色葡萄球菌對(duì)青霉素的耐藥率為97.73%,對(duì)萬古霉素、替考拉寧、利奈唑胺的耐藥率為0,對(duì)其他常用抗菌藥物的耐藥率介于9.09%~61.36%。結(jié)論住院患者下呼吸道感染病原菌以細(xì)菌為主,但真菌和分枝桿菌也不容忽視。銅綠假單胞菌對(duì)常用抗菌藥物的耐藥率相對(duì)較低,但鮑曼不動(dòng)桿菌的耐藥現(xiàn)象則較嚴(yán)重。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogens in patients with lower respiratory tract infection and to provide evidence for rational selection of antimicrobial agents. Methods Pulmonary alveolar lavage fluid samples from January 1, 2013 to December 31, 2014 were cultured in a hospital. Results A total of 999 strains were isolated from 7 702 specimens of alveolar lavage fluid, including 398 strains (5.17%), 326 strains (4.23%) and 275 strains (3.57%) of bacteria, fungi and mycobacteria, respectively. Bacteria include Pseudomonas aeruginosa (97), Acinetobacter baumannii (87), Klebsiella pneumoniae (62), Staphylococcus aureus (44), Haemophilus influenzae (28). Fungi mainly include Candida albicans (161 strains), Aspergillus fumigatus (41 strains), Aspergillus flavus (38 strains) and Mycobacterium tuberculosis (271 strains). The drug resistance of Pseudomonas aeruginosa to common antimicrobial agents (except ticacillin / clavulanic acid and levofloxacin) was 30.005%. The resistance rates of Acinetobacter baumannii to ampicillin / sulbactam, imipenem, amikacin, gentamicin and tobramycin were 80.00g. There were 20 strains of extended-spectrum 尾 -lactamase (ESBLs) in 62 strains of Klebsiella pneumoniae. The resistance rate of Staphylococcus aureus to penicillin, vancomycin, teicoplanin and methicillin-resistant Staphylococcus aureus to penicillin was 97.73, 26 of 44 strains of Staphylococcus aureus were methicillin-resistant Staphylococcus aureus, and the resistance rate of Staphylococcus aureus to penicillin was 97.73. The drug resistance rate of linazolamide was 0, and the resistance rate to other commonly used antibiotics was between 9.09 and 61.363. Conclusion bacteria are the main pathogens of lower respiratory tract infection in inpatients, but fungi and mycobacteria can not be ignored. The resistance rate of Pseudomonas aeruginosa to common antimicrobial agents was relatively low, but that of Acinetobacter baumannii was more serious.
【作者單位】： 華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬同濟(jì)醫(yī)院;
【基金】：國家科技重大專項(xiàng)(2017ZX10103005-007)
【分類號(hào)】：R56

【參考文獻(xiàn)】

相關(guān)期刊論文 前4條

1 陳少文;林，

本文編號(hào)：2425486