中国当代医药
中國噹代醫藥
중국당대의약
PERSON
2015年
14期
148-150
,共3页
门诊%呼吸道感染%病原菌%分布%抗菌药物%耐药性
門診%呼吸道感染%病原菌%分佈%抗菌藥物%耐藥性
문진%호흡도감염%병원균%분포%항균약물%내약성
Outpatient clinic%Respiratory tract infection%Pathogenic bacteria%Distribution%Antimicrobial agents%Drug re-sistance
目的：探讨门诊患者呼吸道感染主要病原菌分布及其常用抗菌药物的使用情况。方法选取2010年1月~2014年1月门诊收治的829例呼吸道感染患者作为研究对象，将呼吸道黏膜作为标本进行分离、培养、鉴定，然后采用Kirby-Bauer(KB)法进行抗菌药物敏感性检测。结果829例使用抗菌药物的呼吸道感染患者共提供痰和咽拭子标本1651份，分离培养出细菌568株(30.3%)，其中革兰氏阴性菌469株(81.1%)，革兰氏阳性菌67株(11.8%)，真菌42株(7.4%)。氧致病菌培养阳性率为34.4%。829例均有抗菌药物使用史，其中头孢菌素类368例(44.39%)，氨基糖苷类278例(33.53%)，大环内酯类66例(7.96%)。使用2种抗菌药物者276名(33.29%)，使用3种抗菌药物者69名(8.32%)。抗菌药物的平均使用天数2.74 d。铜绿假单胞菌对哌拉西林、环丙沙星耐药率较低，肺炎克雷伯菌对头孢噻肟、头孢哌酮耐药率较低，大肠埃希菌对头孢曲松、头孢哌酮耐药率较低，金黄色葡萄球菌对头孢唑林、氧氟沙星耐药率较低。结论门诊患者呼吸道感染的主要病原菌对于一些常用抗菌药物有不同的耐药性，应依据感染菌种药敏试验的分析结果选用抗菌药物，细菌学检查是合理选用抗菌药物和减少细菌耐药的最佳方法。
目的：探討門診患者呼吸道感染主要病原菌分佈及其常用抗菌藥物的使用情況。方法選取2010年1月~2014年1月門診收治的829例呼吸道感染患者作為研究對象，將呼吸道黏膜作為標本進行分離、培養、鑒定，然後採用Kirby-Bauer(KB)法進行抗菌藥物敏感性檢測。結果829例使用抗菌藥物的呼吸道感染患者共提供痰和嚥拭子標本1651份，分離培養齣細菌568株(30.3%)，其中革蘭氏陰性菌469株(81.1%)，革蘭氏暘性菌67株(11.8%)，真菌42株(7.4%)。氧緻病菌培養暘性率為34.4%。829例均有抗菌藥物使用史，其中頭孢菌素類368例(44.39%)，氨基糖苷類278例(33.53%)，大環內酯類66例(7.96%)。使用2種抗菌藥物者276名(33.29%)，使用3種抗菌藥物者69名(8.32%)。抗菌藥物的平均使用天數2.74 d。銅綠假單胞菌對哌拉西林、環丙沙星耐藥率較低，肺炎剋雷伯菌對頭孢噻肟、頭孢哌酮耐藥率較低，大腸埃希菌對頭孢麯鬆、頭孢哌酮耐藥率較低，金黃色葡萄毬菌對頭孢唑林、氧氟沙星耐藥率較低。結論門診患者呼吸道感染的主要病原菌對于一些常用抗菌藥物有不同的耐藥性，應依據感染菌種藥敏試驗的分析結果選用抗菌藥物，細菌學檢查是閤理選用抗菌藥物和減少細菌耐藥的最佳方法。
목적：탐토문진환자호흡도감염주요병원균분포급기상용항균약물적사용정황。방법선취2010년1월~2014년1월문진수치적829례호흡도감염환자작위연구대상，장호흡도점막작위표본진행분리、배양、감정，연후채용Kirby-Bauer(KB)법진행항균약물민감성검측。결과829례사용항균약물적호흡도감염환자공제공담화인식자표본1651빈，분리배양출세균568주(30.3%)，기중혁란씨음성균469주(81.1%)，혁란씨양성균67주(11.8%)，진균42주(7.4%)。양치병균배양양성솔위34.4%。829례균유항균약물사용사，기중두포균소류368례(44.39%)，안기당감류278례(33.53%)，대배내지류66례(7.96%)。사용2충항균약물자276명(33.29%)，사용3충항균약물자69명(8.32%)。항균약물적평균사용천수2.74 d。동록가단포균대고랍서림、배병사성내약솔교저，폐염극뢰백균대두포새우、두포고동내약솔교저，대장애희균대두포곡송、두포고동내약솔교저，금황색포도구균대두포서림、양불사성내약솔교저。결론문진환자호흡도감염적주요병원균대우일사상용항균약물유불동적내약성，응의거감염균충약민시험적분석결과선용항균약물，세균학검사시합리선용항균약물화감소세균내약적최가방법。
Objective To explore the main distributions of pathogenic bacteria in outpatient’s respiratory tract infection and application of common antimicrobial agents. Methods 829 outpatients with respiratory tract infection from January 2010 to January 2014 in outpatient clinic were selected as the research object,the mucosa of respiratory tract as speci-mens were separated,cultured and identified,then tested for sensitivity of antibacterial agents by Kirby-Bauer (KB) method. Results There were 1651 sputum and throat swab specimens from 829 patients with respiratory tract infection treated by antibacterial agents.568 strains of bacteria were separated and cultured,and the positive rate was 30.3%. There were Gram-negative bacteria in 469 strains accounting for 81.1%, 67 strains of Gram-positive bacteria for 11.8%,and 42 strains of fungi accounting for 7.4%.The positive rate of pathogenic bacterium was 34.4%.829 partici-pants had medical history of using antibacterial drugs,cephalosporins were used in 368 cases (44.39%),aminoglycosides were used in 278 csaes(33.53%),macrolides were used in 66 csaes(6.51%).There were 276 patients using two kinds of antimicrobial agents and took the percentage of 33.29% in all patients with acute respiratory tract infection.There were 69 patients using 3 kinds of antimicrobial agents accounting for 8.32%in all patients with acute respiratory tract infec-tion.The average time of using antibacterial agents lasted 2.74 d.The drug resistant rates of Pseudomonas aeruginosa on ciprofloxacin and ciprofloxacin was relatively low,the drug resistant rates of Klebsiella pneumonia on cefotaxime and cefoperazone was relatively low, the drug resistant rates of Escherichia coli on ceftriaxone and cefoperazone was rela-tively low,the drug resistant rates of Staphylococcus aureus on cefazolin and levofloxacin was relatively low. Conclusion The main pathogenic bacteria of outpatient’s respiratory tract infection have different drug-resistance on some common antibacterial agents.Selection of antibiotics should base on the results of drug sensitivity analysis of infected bacteria. Bacteriological examination is a best way to rationally select antibacterial agents and reduce drug-resistance.
