CAJ | 학술논문

目的了解我院下呼吸道感染患者病原菌分布及抗生素耐药情况.方法对我院2006至2008年住院及门诊确诊的下呼吸道感染患者的痰液标本进行细菌培养,并采用美国德灵公司MicroscanA/S-4半自动细菌鉴定及药敏分析仪以及其配套的鉴定和药敏板对阳性标本进行细菌鉴定和药敏试验,并对试验结果进行分析.结果细菌分布以革兰阴性杆菌为主,前5位的致病菌为铜绿假单胞菌、肺炎克雷伯氏菌、鲍曼/溶血不动杆菌、嗜麦芽黄单胞菌、大肠埃希氏菌.药物敏感试验显示,大多数革兰阴性菌对广谱抗生素的耐药率升高.铜绿假单胞菌对菌必治、头孢噻肟耐药率均在60%以上;肺炎克雷伯氏菌及大肠埃希氏菌对青霉素类的耐药率在80%以上,对头孢菌素类及氨曲南的耐药率在50%左右;鲍曼/溶血不动杆菌对大多数抗生素的耐药率在70%以上;嗜麦芽黄单胞菌对头孢菌素类、喹诺酮类及氨基糖苷类的耐药率在90%以上.革兰阳性菌以凝固酶阴性的葡萄球菌为主,其对青霉素类、头孢菌素类的耐药率在85%以上,金黄色葡萄球菌对大多数抗生素的耐药率较低.结论临床上应重视细菌性下呼吸道感染的细菌分布及对药物的耐药率变迁,合理使用抗生素.
목적 료해아원하호흡도감염환자병원균분포급항생소내약정황.방법 대아원2006지2008년주원급문진학진적하호흡도감염환자적담액표본진행세균배양,병채용미국덕령공사MicroscanA/S-4반자동세균감정급약민분석의이급기배투적감정화약민판대양성표본진행세균감정화약민시험,병대시험결과진행분석.결과 세균분포이혁란음성간균위주,전5위적치병균위동록가단포균、폐염극뢰백씨균、포만/용혈불동간균、기맥아황단포균、대장애희씨균.약물민감시험현시,대다수혁란음성균대엄보항생소적내약솔승고.동록가단포균대균필치、두포새우내약솔균재60%이상;폐염극뢰백씨균급대장애희씨균대청매소류적내약솔재80%이상,대두포균소류급안곡남적내약솔재50%좌우;포만/용혈불동간균대대다수항생소적내약솔재70%이상;기맥아황단포균대두포균소류、규낙동류급안기당감류적내약솔재90%이상.혁란양성균이응고매음성적포도구균위주,기대청매소류、두포균소류적내약솔재85%이상,금황색포도구균대대다수항생소적내약솔교저.결론 림상상응중시세균성하호흡도감염적세균분포급대약물적내약솔변천,합리사용항생소.
Objective To investigate the distribution and antibiotic resistance of pathogens in the patients with lower respiratory infections in our hospital. Methods Bacterial culture was preformed from sputum specimens of diagnosed patients with lower respiratory infections in our hospital. Bacterium's appraisal and antimi-crobial susceptibility test for positive specimens were preformed by the Microscan A/S-4 semi-automatic bacteria of America's spirit company and drug susceptibility analyzer and its supporting identification and drug susceptibility plate. Results Gram-negative bacilli were the major microorganism in bacterium. The top 5 pathogens are Pseudomo-nas aeruginosa, pneumonia crayresearch bacteria, baumanii/haemolyticus, Xanthomonas maltophilia and Escheri-chia coli. Drug sensitive experiments showed the resistance rate of gram-negative bacteria to broad-spectrum antibi-otics was increased. Drug resistance rate of pseudomonas aeruginosa against Ceftriaxine, pneumonia crayresearch bacteria and colon bacillus against penicillins and cephalosporin and Ammonia Qu Na was above 60%, 80% and 50% respectively. The resistant rate of Baoman/hematolysis bacillus to the majority antibiotics is above 70%, which of Xanthomonas maltophilia to cephalosporins, quinolones and aminoglycosides were above 90%. Coagulase-negative staphylococcus as the core of Gram-positive bacteria, the resistant rate to Penicillin and cephalosporin are above 85%. The resistance rate of staphylococcus to the majority antibiotics was comparatively low. Conclusions More attention should be paid on distribution and diversify of bacterium in lower respiratory infections clinically and rational use of antibiotics.