呼吸病房感染病原菌的分布及耐药性分析

Distribution of infective bacteria in respiratory ward and analysis on drug resistance in 2009

关键词:  病原菌  抗生素  耐药性

Key words:  infective bacteria  antibiotics  drug resistance

摘要:

［目的］了解呼吸病房感染的病原菌分布情况，并且对病原菌对抗菌药物的耐药情况进行分析。［方法］对大连医科大学附属第一医院2009年呼吸病房患者痰标本进行培养鉴定及药敏试验，同时检测超广谱β内酰胺酶（extended spectrum β lactamases，ESBLs）及耐甲氧西林葡萄球菌（methicillin-resistant staphylococcus，MRS）。［结果］呼吸病房感染以革兰氏阴性菌为主，占79.29%，真菌感染次之，占11.62%，革兰氏阳性菌仅占9.09%。感染的革兰氏阴性杆菌中，以肺炎克雷伯菌和铜绿假单胞菌为主，各占23.74%、23.23%。在20株产ESBLs的菌株中有15株为肺炎克雷伯菌；5株为大肠埃希氏菌。产ESBLs的菌株中亚胺培南、美洛培南、头孢哌酮 /舒巴坦的耐药率均为0。铜绿假单胞菌株中，头孢派酮/舒巴坦的耐药率最低。17株葡萄球菌中MRS有16株，占94.12%。万古霉素的耐药率为0。真菌感染以白色假丝酵母菌为主。5－胞嘧啶、两性霉素B的敏感率均为100%。［结论］2009年呼吸病房感染病原菌以革兰氏阴性菌为主，ESBLs及MRS耐药菌株的比例较高，真菌感染的比率较高。实验室及临床均应给予足够的重视，加强抗生素的合理使用。

Abstract:

［Objective］To understand the distribution of infective bacteria in patients in the respiratory ward at the hospital in 2009,and analysis on drug resistance.［Methods］The sputum specimens from the patients in respiratory ward in 2009 were cultured and identified,and then the susceptibility test was performed.At the same time,the extended spectrum β lactamases (ESBLs) and the methicillin-resistant staphylococcus (MRS) were detected.［Results］The main infective bacteria in the patients in 2009 were Gram-negative bacteria (79.29%).The next was fungi (11.62%).And then it was Gram-positive bacteria (9.09%).The most common strains were Klebsiells pneumonia (23.74%) and Pseudomonas aeruginosa (23.23%).Twenty strains of ESBLs were isolated.Fifteen of them were Klebsiells pneumonia and five strains were Escherichiacoli.The resistance rates of imipenem,meropenem and cefoperazone/sulbactam were zero.The resistance rate of cefoperazone/sulbactam was lowest in the Pseudomonas aeruginosa strains.Seventeen strains of staphylococci were isolated,and 16 strains of MRS were isolated (94.12%).The resistance rate of vancomycin was zero.The main fungi were Candida albicans.The sensitive rates of 5-Cytosine and Amphotericin B were 100%.［Conclusion］The main infective bacteria in respiratory ward in 2009 are Gram-negative bacteria.The isolated rates of ESBLs and MRS are high.The rate of fungous infection is high.The results are important for clinical practitioners to use antibiotics more carefully.