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目的对本院2015年下呼吸道感染患者的痰标本进行病原体的分离鉴定,分析细菌分布和耐药性,为临床选择抗菌药物治疗提供参考。方法对2015年于本院住院的下呼吸道感染患者的送检痰标本4808份进行细菌分离培养及鉴定。结果 (1)4808份送检痰标本中,共培养出菌株277株。其中,培养出革兰阴性菌167株(60.3%),革兰阳性菌64株(23.1%),真菌46株(16.6%)。(2)肺炎克雷伯杆菌、大肠埃希氏菌、铜绿假单胞菌对泰能的耐药率分别为2.0%、0.5%、27.0%,对哌拉西林/他唑巴坦(P/T)的耐药率分别为5.0%、2.5%、20.8%,对头孢吡肟的耐药率分别为20.8%、44.9%、24.3%。(3)金黄色葡萄球菌、表皮葡萄球菌对青霉素的耐药率最高,分别为85.5%、85.9%;对左氧氟沙星的耐药率较低,分别为28.9%、28.9%;对万古霉素的耐药率最低,分别为0、0。(4)白色念珠菌对伊曲康唑和氟康唑耐药率最高,分别为3.1%和3.1%;光滑念珠菌对伊曲康唑耐药率最高,为40.0%;热带念珠菌对伊曲康唑耐药率最高,为50.0%;其他酵母菌对伊曲康唑耐药率最高,为24.5%。结论应对病原菌分布及耐药率加强监测,根据药敏结果合理选择抗感染治疗。
Objective To isolate and identify the pathogen of sputum from patients with lower respiratory tract infection in our hospital in 2015 and analyze the distribution and drug resistance of the bacteria and provide reference for the clinical choice of antimicrobial agents. Methods 4808 sputum specimens from patients with lower respiratory tract infection hospitalized in our hospital were collected for bacterial isolation and identification. Results (1) 4808 sputum samples sent to seize a total of 277 strains of strains. Among them, 167 (60.3%) were gram-negative bacteria, 64 (23.1%) were gram-positive bacteria and 46 (16.6%) were fungi. (2) The susceptibilities to Klebsiella pneumoniae, Escherichia coli and Pseudomonas aeruginosa were 2.0%, 0.5% and 27.0%, respectively. The resistance rate to piperacillin / tazobactam (P / T) were 5.0%, 2.5% and 20.8% respectively. The resistance rate to cefepime was 20.8%, 44.9% and 24.3% respectively. (3) Staphylococcus aureus and Staphylococcus epidermidis showed the highest rates of resistance to penicillin, which were 85.5% and 85.9%, respectively. The resistance rate to levofloxacin was 28.9% and 28.9%, respectively. The resistance to vancomycin The lowest rates were 0,0. (4) Candida albicans had the highest rates of resistance to itraconazole and fluconazole, which were 3.1% and 3.1%, respectively; the highest rate of Candida glabrata to itraconazole was 40.0% The highest rate of resistance to itraconazole was 50.0%. The highest rates of resistance to itraconazole in other yeasts were 24.5%. Conclusion The distribution of pathogens should be strengthened and the drug resistance rate should be strengthened to be monitored. According to the results of drug susceptibility, the anti-infective treatment should be rationally selected.