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目的分析医院重症下呼吸道感染患者多重耐药革兰阴性杆菌的耐药情况,为今后临床治疗方案的制定提供依据。方法收集2013年1月-2014年6月之间,全院呼吸内科ICU收治的重症下呼吸道感染住院患者痰液标本388例进行培养,分析病原菌的检出情况及主要革兰阴性杆菌对常用抗菌药的耐药情况以及多重耐药的发生情况。结果本次送检的388份痰液标本中,共分离出革兰阴性菌258株(66.49%)、革兰阳性菌87株(22.42%)、真菌43株(11.08%)。在本次检出的革兰阴性菌中,通过药敏实验,共分离出多重耐药革兰阴性菌55株,其中肺炎克雷伯菌11株(20.00%),铜绿假单胞菌23株(41.82%),大肠埃希菌21株(38.18%)。结论在医院重症下呼吸道感染患者中,革兰阴性菌感染所占比例较高,多重耐药情况严重,临床治疗根据致病菌检验结果及药敏实验合理选择治疗用药、规范使用抗菌药物是提高治疗效果、遏制多重耐药发生的关键。
Objective To analyze the drug resistance of multi-drug resistant Gram-negative bacilli in patients with severe lower respiratory tract infection in hospital, and to provide the basis for the future clinical treatment plan. Methods 388 cases of sputum samples from hospitalized patients with severe lower respiratory tract infection admitted to the hospital from January 2013 to June 2014 were collected and analyzed for the detection of pathogenic bacteria and the prevalence of gram- Drug resistance and multi-drug resistance situation. Results A total of 258 strains of Gram-negative bacteria (66.49%), 87 strains (22.42%) of Gram-positive bacteria and 43 strains (11.08%) of fungi were isolated from 388 sputum samples. Among the Gram-negative bacteria detected in this study, 55 strains of multi-drug-resistant Gram-negative bacteria were isolated, including 11 strains of Klebsiella pneumoniae (20.00%), 23 strains of Pseudomonas aeruginosa (41.82%) and 21 Escherichia coli (38.18%). Conclusions Among the patients with severe lower respiratory tract infection in hospital, the proportion of Gram-negative bacteria infection is high and the multi-drug resistance is serious. According to the results of pathogenic bacteria test and drug susceptibility test, the clinical treatment is reasonable, and the use of antibacterial drugs is increased Therapeutic effect, the key to contain multiple drug resistance.