下呼吸道分离菌11106株的分布及耐药性分析

发布时间：2018-09-08 06:51

【摘要】：目的:了解下呼吸道分离菌的分布及耐药特征,为临床合理用药提供指导和依据。方法:对郑州大学第一附属医院2016年1月至12月下呼吸道标本分离的非重复菌株进行回顾性分析,按CLSI 2015年版标准判读药敏结果。结果:下呼吸道标本共分离出11 106株细菌,革兰阴性菌占77.7%,革兰阳性菌占6.5%,真菌占15.8%。常见分离菌依次为鲍曼不动杆菌(26.4%)、肺炎克雷伯菌(22.1%)、铜绿假单胞菌(16.6%)、金黄色葡萄球菌(5.8%)和大肠埃希菌(3.2%)。药敏结果显示,肠杆菌科细菌对碳青霉烯类最敏感,肺炎克雷伯菌和大肠埃希菌产ESBL菌株检出率分别为50.0%和62.1%,产ESBL菌株对抗菌药物的耐药率均高于非产ESBL菌株。鲍曼不动杆菌耐药现象最严重。铜绿假单胞菌对氨基糖苷类敏感性最高。MRSA检出率为58.6%。呼吸科多重耐药株检出率最高,其次为ICU。结论:医院下呼吸道分离菌耐药现象严重。临床医师应重视病原学检查并根据药敏结果合理选择抗菌药物。
[Abstract]:Objective: to investigate the distribution and drug resistance of bacteria isolated from lower respiratory tract and to provide guidance and basis for rational drug use. Methods: the non-repetitive strains isolated from the lower respiratory tract samples from the first affiliated Hospital of Zhengzhou University from January to December 2016 were retrospectively analyzed and the drug sensitivity results were interpreted according to the CLSI 2015 standard. Results: 11 106 strains of bacteria were isolated from lower respiratory tract specimens. Gram-negative bacteria accounted for 77.7. Gram-positive bacteria accounted for 6.5 and fungi accounted for 15.8. The common isolates were Acinetobacter baumannii (26.4%), Klebsiella pneumoniae (22.1%), Pseudomonas aeruginosa (16.6%), Staphylococcus aureus (5.8%) and Escherichia coli (3.2%). The results of antimicrobial susceptibility showed that Enterobacteriaceae bacteria were most sensitive to carbapenes. The detection rates of Klebsiella pneumoniae and Escherichia coli ESBL strains were 50.0% and 62.1%, respectively. The antimicrobial resistance rate of ESBL producing strains was higher than that of non-producing ESBL strains. Acinetobacter baumannii is the most resistant. The sensitivity of Pseudomonas aeruginosa to aminoglycosides was the highest. MRSA was 58.6%. The detection rate of multidrug resistant strains in respiratory department was the highest, followed by ICU.. Conclusion: the drug resistance of bacteria isolated from lower respiratory tract in hospital is serious. Clinicians should pay attention to etiological examination and select antibiotics reasonably according to drug sensitivity results.
【作者单位】：郑州大学第一附属医院检验科;
【基金】：河南省科技发展计划项目162102310509
【分类号】：R446.5

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