呼吸科住院患者痰液病原菌和耐药性变迁分析.docVIP

呼吸科住院患者痰液病原菌和耐药性变迁分析 　　[摘要]目的 探讨呼吸科住院患者痰液病原菌与耐药性变迁。方法 选择2015年7月～2017年6月在我院呼吸科接受住院治疗患者痰液的阳性标本，利用上海复兴仪器进行培养结果鉴定；药敏结果测试利用MIC法和K-B法；药敏分析使用WHONET 5.4软件。结果 在送检的痰液标本1300份中，检出病原菌160株，检出率为12.3%。其中革兰阳性菌株26株，占16.2%；革兰阴性菌株105株，占65.6%；真菌菌株29株，占18.2%；前3位分离最多菌株的病原菌分别为肺炎克雷伯菌37株（23.1%），真菌菌株29株（18.2%），铜绿假单胞菌25株（15.6%）。革兰阴性菌耐药率较低的抗菌药物包括头孢哌酮/舒巴坦及亚胺培南等，金黄色葡萄球菌耐药率较低的抗菌药物包括利奈唑胺、替考拉宁以及万古霉素等。相较于2015年7月～2016年6月，2016年7月～2017年6月的耐药性呈上升趋势。结论 呼吸科患者痰液病原菌主要为革兰阴性菌，对常用抗生素显著耐药呈逐渐上升趋势发展。 　　[关键词]呼吸科；住院患者；病原菌；耐药性 　　[中图分类号] R446.19 [文献标识码] A [文章编号] 1674-4721（2018）3（c）-0112-03 　　[Abstract]Objective To investigate the changes of pathogens and Antibiotic resistance in sputum of respiratory inpatients.Methods The positive specimens of sputum from July 2015 to June 2017 in the hospitalized patients in the Department of respiration in our hospital were selected，the results of culture were identified by Shanghai Fuxing instrument.Antibiotic sensitivity test was performed by MIC and K-B methods.WHONET 5.4 software was used for drug sensitivity analysis.Results Among 1300 sputum samples，160 strains of pathogenic bacteria were detected，and the detection rate was 12.3%.Among them，26 cases were Gram positive strains （16.2%），105 cases were Gram-negative strains （65.6%），and there were 29 strains of fungi （18.2%）.The isolated pathogens from the top 3 isolates were Klebsiella pneumoniae in 37 strains （23.1%），fungi in 29 strains （18.2%），Pseudomonas aeruginosa in 25 strains （15.6%） respectively.The antimicrobial agents with lower drug resistance of Gram-negative bacteria included Cefoperazone/Sulbactam and Imipenem，etc.Antimicrobial agents with low resistance to Staphylococcus aureus included Linezolid and Teicoplanin and Vancomycin.Compared with July 2015 to June 2016，the drug resistance was in a rising trend from July 2016 to June 2017.Conclusion The sputum pathogens in the patients in respiratory department are mainly gram-negative bacteria，and they are significantly resistant to commonly used antibiotics，which is