下呼吸道感染患者痰培养病原菌分布及耐药性检测

发布时间：2018-02-20 22:38

本文关键词： 下呼吸道感染病原菌抗菌药物耐药　出处：《山东医药》2016年42期 　论文类型：期刊论文

【摘要】：目的观察下呼吸道感染患者的痰培养病原菌的分布及耐药情况。方法从下呼吸道感染患者送检的合格痰标本中分离出1 333株病原菌,采用TDR-300B全自动微生物鉴定分析仪进行菌种鉴定和药敏检测,采用纸片扩散法确认超广谱β内酰胺酶(ESBLS)。结果 1 333株致病菌中,革兰阴性菌931株,革兰阳性菌297株,真菌105株;其中,分布前5位的是铜绿假单胞菌358株、大肠埃希菌195株、肺炎克雷伯菌187株、金黄色葡萄球菌92株、嗜麦芽寡养假单胞菌65株。2014年革兰阴性杆菌中大肠埃希菌和肺炎克雷伯菌产ESBLS菌株比例分别为29.6%、45.4%,2015年分别为33.2%、35.0%。2014年革兰阳性球菌中耐甲氧西林的金黄色葡萄球菌(MRSA)菌株比例为35.2%,2015年为41.0%。革兰阴性杆菌对美洛培南及阿米卡星敏感率90%,对其他抗菌药物都表现出不同程度的耐药。革兰阳性球菌对青霉素、红霉素、阿奇霉素、克林霉素耐药率均75%,对万古霉素、利奈唑胺、氯霉素、米诺环素100%敏感;真菌对常用抗菌药物的敏感率80%。结论革兰阴性杆菌为下呼吸道感染主要病原菌,产ESBLS菌株增加,耐药现象严重;MRSA比例增加,应引起重视。
[Abstract]:Objective to observe the distribution and drug resistance of pathogenic bacteria in sputum culture of patients with lower respiratory tract infection. Methods 1 333 strains of pathogenic bacteria were isolated from eligible sputum samples from patients with lower respiratory tract infection. Strain identification and drug sensitivity detection were carried out by TDR-300B automatic microbiological identification analyzer. Extended-spectrum 尾 -lactamases were identified by disk diffusion method. Results among 1 333 strains of pathogenic bacteria, 931 were Gram-negative bacteria, 297 Gram-positive bacteria and 105 fungi. Among them, 358 strains of Pseudomonas aeruginosa, 195 strains of Escherichia coli, 187 strains of Klebsiella pneumoniae and 92 strains of Staphylococcus aureus were among the top 5 strains. In 2014, the proportion of Escherichia coli and Klebsiella pneumoniae producing ESBLS strains in Gram-negative bacilli was 29.65.45.45, respectively, and that in 2015 was 33.20.35. 00.The methicillin-resistant Staphylococcus aureus in Gram-positive cocci in 2014 was found to be resistant to methicillin-resistant Staphylococcus aureus. Gram-negative bacilli were sensitive to melopenem and amikacin 90 percent, and showed resistance to other antimicrobial agents to varying degrees. Gram-positive cocci showed resistance to penicillin. Erythromycin, azithromycin and clindamycin were resistant to vancomycin, linazolamine, chloramphenicol and minocycline 100%, and fungi were 80% sensitive to common antimicrobial agents. Conclusion Gram-negative bacilli are the main pathogens of lower respiratory tract infection. Due to the increase of ESBLS producing strains and the increase of drug resistance, attention should be paid to it.
【作者单位】：临沂罗庄中心医院;
【分类号】：R56;R446.5

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