654例下呼吸道感染患者痰培养病原菌及其药物敏感试验研究.docVIP

654例下呼吸道感染患者痰培养病原菌及其药物敏感试验研究【摘要】　目的：分析下呼吸道感染的常见病原菌及其对抗菌药物的敏感性，为临床合理使用抗菌药物提供科学依据。方法：回顾性分析2009年1月-2011年10月654例痰培养病原菌的耐药性资料。结果：654例下呼吸道感染患者的痰标本共检出病原菌421株，检出率为64.4%，其中革兰阴性杆菌323株，占76.7%，前3位分别为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌；革兰阳性球菌52株，占12.4%，以金黄色葡萄球菌为主；真菌28株，占6.7%。大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍氏不动杆菌对碳青霉烯类、氨基糖苷类敏感性较高，对头孢菌素类也产生了不同程度的耐药，而对氨苄西林的耐药率最高，达80%以上。革兰阳性菌对利奈唑胺、替考拉宁、奎奴普汀-达福普汀100%敏感，对利福平、环丙沙星敏感性较高，对克拉霉素、青霉素、四环素、阿奇霉素均高度耐药。结论：老年患者下呼吸道感染的主要病原菌为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌等革兰阴性杆菌，其次为金黄色葡萄球菌及真菌。不同细菌对不同抗菌药物敏感性不同，因此，应该加强药物敏感性试验，建立早期预警系统，指导临床合理用药。 【关键词】　抗菌药物；　合理用药；　病原菌；　敏感性；　耐药性 The Distribution and Drug Susceptibility of the Primary Pathogens from Sputum Culture in 654 Patients with Lower Respiratory Tract Infection/CHEN Zai-ling.//Medical Innovation of China，2012，9(23):138-140 【Abstract】　Objective:To investigate the distribution of primary pathogens from sputum culture in the patients with lower respiratory tract infection and analyze the antimicrobial susceptibility and to provide evidences for clinical therapy.Method:The data of the distribution and antimicrobial susceptibility of the pathogens，which were isolated from the patients in our hospital by sputum culture from Jan.2009 to Oct.2011，were studied retrospectively.Result:Totally 421 strains of pathogens，including fungi，were isolated from 654 sputum specimens，and the relevance ratio of the pathogens was 64.4%.323 strains were Gram negative bacilli(76.7%)，among which the top three were Escherichia coli，Klebsiella pneumoniae，Pseudomonas aeruginosa.52 strains were Gram positive cocci(12.4%)，among which the most common was Staphylococcus aureus.28 strains were fungi，accounted for 6.7%.Escherichia coli，Klebsiella pneumoniae，Pseudomonas aeruginosa，Acinetobacter baumanii were more sensitivity to carbapenems，aminoglycosides，and resistant to cephalosporins to some extent，and most resistant to ampicillin.Their drug resistance rates to ampicillin were over 80%.All gram negative bacilli were sensitive to Linezolid，teicoplanin，quinupristin-dalfoprisdn enti