2013—2015年某院患者下呼吸道感染病原菌分布及耐药性

发布时间：2019-02-17 18:56

【摘要】：目的探讨下呼吸道感染患者的病原菌分布及耐药性,为临床合理选择抗菌药物提供依据。方法对某院2013年1月1日—2014年12月31日送检的肺泡灌洗液标本进行培养,采用纸片扩散法对阳性标本菌株进行药敏试验。结果 7 702份肺泡灌洗液标本共分离菌株999株,其中细菌、真菌和分枝杆菌分别为398株(5.17%)、326株(4.23%)和275株(3.57%)。细菌主要包括铜绿假单胞菌(97株)、鲍曼不动杆菌(87株)、肺炎克雷伯菌(62株)、金黄色葡萄球菌(44株)、流感嗜血杆菌(28株);真菌主要包括白假丝酵母菌(161株)、烟曲霉菌(41株)、黄曲霉菌(38株);分枝杆菌主要包括结核分枝杆菌(271株)。药敏结果显示铜绿假单胞菌对常用抗菌药物(除替卡西林/克拉维酸和左氧氟沙星外)的耐药率均30.00%。鲍曼不动杆菌对氨苄西林/舒巴坦、亚胺培南、阿米卡星、庆大霉素和妥布霉素的耐药率均80.00%,对其他常用抗菌药物的耐药率介于36.84%~60.53%。62株肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)有20株。产ESBLs株的耐药率明显高于非产ESBLs株。44株金黄色葡萄球菌中26株为耐甲氧西林金黄色葡萄球菌(MRSA),金黄色葡萄球菌对青霉素的耐药率为97.73%,对万古霉素、替考拉宁、利奈唑胺的耐药率为0,对其他常用抗菌药物的耐药率介于9.09%~61.36%。结论住院患者下呼吸道感染病原菌以细菌为主,但真菌和分枝杆菌也不容忽视。铜绿假单胞菌对常用抗菌药物的耐药率相对较低,但鲍曼不动杆菌的耐药现象则较严重。
[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.
【作者单位】：华中科技大学同济医学院附属同济医院;
【基金】：国家科技重大专项(2017ZX10103005-007)
【分类号】：R56

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