呼吸科下呼吸道感染革兰阴性菌耐药性剖析.docVIP

呼吸科下呼吸道感染革兰阴性菌耐药性剖析 　　【摘要】 目的：了解下呼吸道感染革兰阴性菌种类分布及耐药情况，为临床合理选用抗菌药物及控制感染提供病原学依据。方法：本研究通过收集2013-2014年笔者所在医院呼吸内科诊断为下呼吸道感染的住院患者所留取的合格痰标本，进行菌种鉴定及药敏试验，并对所分离革兰阴性菌株的分布及耐药性结果进行回顾性分析。结果：笔者所在医院共分离到革兰阴性菌912株，其中前4位分别是鲍曼不动杆菌（22.9%）、肺炎克雷伯菌（19.2%）、洛菲不动杆菌（13.2%）、铜绿假单胞菌（10.6%）。鲍曼不动杆菌对头孢哌酮/舒巴坦的耐药率相对较低为1.4%，对亚胺培南、美罗培南的耐药率分别为11.5%、12.9%。肺炎克雷伯菌对亚胺培南、美罗培南、头孢吡肟、阿米卡星、头孢哌酮/舒巴坦的耐药率均10%；铜绿假单胞菌头孢吡肟、环丙沙星的耐药率最低均为3.1%，对亚胺培南的耐药率达7.2%。结论：应加强对感染病原菌及其耐药率的监测，根据药敏结果选用敏感性高的药物进行治疗。 　　【关键词】 下呼吸道感染； 耐药性； 抗生素 　　doi：10.14033/j.cnki.cfmr.2017.1.026 文献标识码 B 文章编号 1674-6805（2017）01-0048-03 　　【Abstract】 Objective：To understand the bacilli distribution and drug resistance with lower respiratory tract infection of gram-negative bacteria and provide the etiology for clinical rational use of antimicrobial drugs and infection control.Method：Sputum samples from inpatients diagnosed with lower respiratory tract infections during the period of 2013 to 2014 had been collected in this study，then the pathogens was identified and drug susceptibility tests was done，and the separation of gram-negative bacteria results were retrospectively analyzed.Result：912 gram-negative bacillis were isolated.The most common four gram-negative bacillis were acinetobacter baumannii（22.9%），klebsiella pneumoniae（19.2%），acinetobacter lwoffii（13.2%），pseudomonas aeruginosa（10.6%）.Acinetobacter baumannii showed lower resistance to Cefoperazone/Sulbactam（1.4%），but to Imipenem，Meropenem was up to 11.5%，12.9%.Less than 10% of klebsiella pneumoniae had a resistant to Imipenem，Meropenem，Cefepime，Amikacin，Cefoperazone/Sulbactam.Pseudomonas aeruginosa of Cefepime，Ciprofloxacin resistance reached to a minimum of 3.1%，the resistant rate of Imipenem was 7.2%.Conclusion：The monitoring of infectious pathogens and their resistance shall be enhanced and high sensitivity drug according to the result of drug susceptibility shall be chose for treatment. 　　【Key words】 Lower respiratory tract infection； Drug resistance； Antibiotics 　　First-author’s address：The Se