医学理论与实践
醫學理論與實踐
의학이론여실천
The Journal of Medical Theory and Practice
2015年
10期
1279-1281
,共3页
下呼吸道感染%病原菌%耐药性
下呼吸道感染%病原菌%耐藥性
하호흡도감염%병원균%내약성
Lower respiratory tract infection%Pathogens%Drug resistance
目的：了解青岛市立医疗集团下呼吸道感染病原菌的分布及耐药特点，为临床医生合理使用抗菌药物提供理论依据。方法：对2012年1月－2013年12月下呼吸道感染患者各类标本分离出的病原菌进行培养，采用 VITEK‐2全自动细菌鉴定仪进行菌种鉴定及药敏试验，双纸片扩散法进行ESBLs的确证试验。结果：分离鉴定的1252株病原菌主要来源于呼吸内科（57．8％）、IC U （15．3％）、神经内科（13．5％）及神经外科（12．1％）。革兰阴性杆菌783株占62．5％，革兰阳性球菌418株占33．4％；真菌51株占4．1％。产 ESBLs大肠埃希菌和肺炎克雷伯菌检出率分别为56．4％和38．7％。革兰阴性杆菌对青霉素类及一代、二代头孢菌素耐药性较高，对亚胺培南等高度敏感，且产酶菌株的耐药率明显高于非产酶菌株。金黄色葡萄球菌除对万古霉素和替考拉宁高度敏感，对其他抗生素耐药率较高。结论：下呼吸道感染分离的病原菌以革兰阴性杆菌为主，且存在多重耐药现象，应引起临床医生的高度重视。
目的：瞭解青島市立醫療集糰下呼吸道感染病原菌的分佈及耐藥特點，為臨床醫生閤理使用抗菌藥物提供理論依據。方法：對2012年1月－2013年12月下呼吸道感染患者各類標本分離齣的病原菌進行培養，採用 VITEK‐2全自動細菌鑒定儀進行菌種鑒定及藥敏試驗，雙紙片擴散法進行ESBLs的確證試驗。結果：分離鑒定的1252株病原菌主要來源于呼吸內科（57．8％）、IC U （15．3％）、神經內科（13．5％）及神經外科（12．1％）。革蘭陰性桿菌783株佔62．5％，革蘭暘性毬菌418株佔33．4％；真菌51株佔4．1％。產 ESBLs大腸埃希菌和肺炎剋雷伯菌檢齣率分彆為56．4％和38．7％。革蘭陰性桿菌對青黴素類及一代、二代頭孢菌素耐藥性較高，對亞胺培南等高度敏感，且產酶菌株的耐藥率明顯高于非產酶菌株。金黃色葡萄毬菌除對萬古黴素和替攷拉寧高度敏感，對其他抗生素耐藥率較高。結論：下呼吸道感染分離的病原菌以革蘭陰性桿菌為主，且存在多重耐藥現象，應引起臨床醫生的高度重視。
목적：료해청도시립의료집단하호흡도감염병원균적분포급내약특점，위림상의생합리사용항균약물제공이론의거。방법：대2012년1월－2013년12월하호흡도감염환자각류표본분리출적병원균진행배양，채용 VITEK‐2전자동세균감정의진행균충감정급약민시험，쌍지편확산법진행ESBLs적학증시험。결과：분리감정적1252주병원균주요래원우호흡내과（57．8％）、IC U （15．3％）、신경내과（13．5％）급신경외과（12．1％）。혁란음성간균783주점62．5％，혁란양성구균418주점33．4％；진균51주점4．1％。산 ESBLs대장애희균화폐염극뢰백균검출솔분별위56．4％화38．7％。혁란음성간균대청매소류급일대、이대두포균소내약성교고，대아알배남등고도민감，차산매균주적내약솔명현고우비산매균주。금황색포도구균제대만고매소화체고랍저고도민감，대기타항생소내약솔교고。결론：하호흡도감염분리적병원균이혁란음성간균위주，차존재다중내약현상，응인기림상의생적고도중시。
Objective:To understand the distribution and drug resistance of pathogenic bacteria causing lower respira‐tory tract infections in Qingdao Municipal Hospital (Group) and provide evidence for the rational use of antimicrobial drugs .Methods:The pathogenic bacteria were cultured from a variety of specimens obtained from the lower respiratory tract infection patients between Jan 2012 and Dec 2013 in Qingdao Municipal Hospital (Group) ,the identification of bacteria and drug sensitivity test were carried out by VITEK‐2 Compact automatic microbiology system .Confirmatory test of extended spectrumβ‐lactamases (ESBLs) were conducted by the double disk diffusion method .Results:A total of 1 252 strains of pathogens were isolated ,57 .8% from the department of respiration ,15 .3% from ICU and 13 .5%from neurology .Gram‐negative bacilli accounted for 62 .5% (783/1 252) ,Gram‐positive cocci were 33 .4% (418/1 252) ,and fungi 4 .1% (51/1 252) .The prevalence of ESBLs producing strains were 56 .4% and 38 .7% in E .coli and K .pneumoniae respectively ,the drug resistance rate of Gram‐negative bacilli to penicillin and cephalosporin were high‐er ,but sensitive to imipenem ,the drug resistance rate of ESBLs producing strains were significantly higher than that of non‐ESBLs producing strains .S .aureus remained highly sensitive to vancomycin and teicoplanin ,but showed high resistance to other antibiotics .Conclusion:The Gram‐negative bacilli were the major pathogenic bacteria causing lower respiratory tract infections ,and it shows multi‐drug resistance ,clinician should pay more attention to the drug resist‐ance .
