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目的探究呼吸内科住院患者下呼吸道感染的病原菌谱及耐药性。方法随机抽取我院2015年1月~2016年1月收治的呼吸内科住院患者956例痰液标本进行检验,分析标本中病原菌的构成情况及其耐药性。结果 956例痰液标本中共分离出481例病原菌,检出率为50.3%。其中革兰阴性菌301株,占62.6%(301/481);革兰阳性菌120株,占24.9%(120/481);真菌60株,占12.5%(60/481)。在革兰阴性菌中,铜绿假单胞菌占比最高,占21.2%(102/481);革兰阳性菌中,肺炎链球菌的占比最高,占12.5%(60/481);真菌中白假丝酵母菌的占比最高,占6.6%(32/481)。革兰阴性菌中铜绿假单胞菌耐药性最严重的是氨苯西林(92.12%)、头孢曲松(79.63%)及头孢唑林(79.85%);肺炎克雷伯菌耐药最严重的是头孢曲松(88.25%)、头孢唑林(87.36%)、氨苯西林(85.69%)及头孢噻肟(79.25%);鲍曼不动杆菌耐药最严重的是头孢曲松(89.69%)、头孢噻肟(85.69%)及头孢唑林(84.62%)。革兰阳性菌中耐甲氧西林葡萄球菌耐药性最严重的是红霉素(100%)、阿莫西林克拉维酸(100%)及四环素(79.63%);金黄色葡萄球菌耐药性最严重的是红霉素(100%)、阿莫西林克拉维酸(100%)及四环素(91.63%);肺炎链球菌耐药性最严重的是红霉素(100%)、阿莫西林克拉维酸(98.63%)及四环素(93.63%).结论下呼吸道感染的患者,革兰阴性菌的占比最大,铜绿假单胞菌是主要的病原菌,致病菌对各种药物的耐药性各不相同,应该根据具体的药敏试验结果合理的使用抗菌药物。
Objective To investigate the pathogenic bacteria spectrum and drug resistance of lower respiratory tract infection in respiratory patients in respiratory medicine. Methods A total of 956 sputum specimens from hospitalized patients with respiratory medicine admitted to our hospital from January 2015 to January 2016 were randomly selected to test the composition of the pathogens and their drug resistance. Results A total of 481 pathogenic bacteria were isolated from 956 sputum samples, the detection rate was 50.3%. Among them, 301 strains of Gram-negative bacteria accounted for 62.6% (301/481); 120 strains of Gram-positive bacteria accounted for 24.9% (120/481); 60 strains of fungi accounted for 12.5% (60/481). Of Gram-negative bacteria, Pseudomonas aeruginosa accounted for the highest proportion, accounting for 21.2% (102/481); Gram-positive bacteria, the highest proportion of Streptococcus pneumoniae, accounting for 12.5% (60/481); fungi Candida albicans accounted for the highest proportion, accounting for 6.6% (32/481). Among the Gram-negative bacteria, Pseudomonas aeruginosa was the most resistant to ampicillin (92.12%), ceftriaxone (79.63%) and cefazolin (79.85%). Klebsiella pneumoniae was the most resistant Were ceftriaxone (88.25%), cefazolin (87.36%), ampicillin (85.69%) and cefotaxime (79.25%). Acinetobacter baumannii was the most resistant to ceftriaxone (89.69%), %), Cefotaxime (85.69%) and cefazolin (84.62%). Gram-positive bacteria in methicillin-resistant Staphylococcus aureus is the most drug-resistant erythromycin (100%), amoxicillin clavulanic acid (100%) and tetracycline (79.63%); Staphylococcus aureus drug resistance The most serious were erythromycin (100%), amoxicillin clavulanic acid (100%) and tetracycline (91.63%). The most resistant strains of S. pneumoniae were erythromycin (100%), amoxicillin Clavulanic acid (98.63%) and tetracycline (93.63%) .Conclusion Gram-negative bacteria account for the largest proportion of patients with lower respiratory tract infection. Pseudomonas aeruginosa is the main pathogen and pathogenic bacteria are resistant to various drugs Sexual differences, should be based on specific susceptibility testing results rational use of antimicrobial agents.