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宿州市第一人民医院检验科
纸质出版日期:2021,
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魏炘. 1636份下呼吸道感染患者痰标本中病原菌分布及药物敏感试验结果分析[J]. 中国医院用药评价与分析, 2021,21(9):1124-1127.
WEI Xin. Distribution of Pathogenic Bacteria and Drug Sensitivity Results in Sputum Samples of 1 636 Patients with Lower Respiratory Tract Infection[J]. 2021,21(9):1124-1127.
魏炘. 1636份下呼吸道感染患者痰标本中病原菌分布及药物敏感试验结果分析[J]. 中国医院用药评价与分析, 2021,21(9):1124-1127. DOI: 10.14009/j.issn.1672-2124.2021.09.024.
WEI Xin. Distribution of Pathogenic Bacteria and Drug Sensitivity Results in Sputum Samples of 1 636 Patients with Lower Respiratory Tract Infection[J]. 2021,21(9):1124-1127. DOI: 10.14009/j.issn.1672-2124.2021.09.024.
目的:了解宿州市第一人民医院(以下简称"我院")下呼吸道感染病原菌分布及其耐药性
以指导临床抗菌药物的合理、有效选用。方法:对2015年1月至2020年1月我院1 636份下呼吸道感染患者合格痰标本进行病原学检查。结果:1 636份痰标本中分离出853株病原菌
包括革兰阴性菌703株(占82.42%)、革兰阳性菌112株(占13.13%)和真菌38株(占4.45%)。药物敏感试验结果显示
铜绿假单胞菌对头孢唑林的耐药率(100.00%)最高
对亚胺培南(4.65%)、美罗培南(4.65%)的耐药率最低;肺炎克雷伯菌对氨苄西林的耐药率(100.00%)最高
对美罗培南(5.00%)、亚胺培南(5.00%)的耐药率最低;大肠埃希菌对氨苄西林的耐药率(57.30%)最高
对美罗培南(1.12%)、亚胺培南(1.12%)的耐药率最低;鲍曼不动杆菌对氨苄西林(100.00%)、头孢唑林(100.00%)的耐药率最高
对美罗培南的耐药率(54.69%)最低;金黄色葡萄球菌对青霉素的耐药率(100.00%)最高
对呋喃妥因(0%)、替加环素(0%)、利奈唑胺(0%)、万古霉素(0%)和左氧氟沙星(0%)的耐药率最低;肺炎链球菌对红霉素(100.00%)、克林霉素(100.00%)和四环素(100.00%)的耐药率最高
对苯唑西林(0%)、阿莫西林(0%)、头孢西丁(0%)、妥布霉素(0%)、利福平(0%)、庆大霉素(0%)、环丙沙星(0%)、替考拉宁(0%)、万古霉素(0%)、呋喃妥因(0%)、替加环素(0%)、利奈唑胺(0%)和左氧氟沙星(0%)的耐药率最低;白假丝酵母菌对氟康唑的耐药率(20.00%)最高
对伏立康唑的耐药率(6.67%)最低;光滑假丝酵母菌对氟康唑(60.00%)、伊曲康唑(60.00%)的耐药率最高
对两性霉素(0%)、伏立康唑(0%)的耐药率最低;热带假丝酵母菌对伊曲康唑的耐药率(66.67%)最高
对两性霉素B(0%)、伏立康唑(0%)的耐药率最低。结论:我院近5年下呼吸道感染病菌以革兰阴性菌为主
对广谱青霉素类药物的耐药性较高
对碳青霉烯类药物及含β-内酰胺酶抑制剂复方制剂的耐药率低。临床上应根据细菌培养结果及耐药率选用抗菌药物
制订个体化治疗方案
提高疗效及遏制多重耐药菌产生。
OBJECTIVE: To investigate the distribution of pathogenic bacteria and drug sensitivity results in lower respiratory tract infection in Suzhou First People’s Hospital( hereinafter referred to as “our hospital”)
so as to guide the rational and effective selection of clinical antibiotics. METHODS: From Jan. 2015 to Jan. 2020
1 636 qualified sputum samples from patients with lower respiratory tract infection in our hospital were examined for etiology.RESULTS: Totally 853 pathogenic bacteria were isolated from 1 636 sputum samples
including 703 Gram-negative bacteria( 82. 42%)
112 Gram-positive bacteria( 13. 13%) and 38 fungi( 4. 45%). The drug sensitivity results showed that Pseudomonas aeruginosa had the highest resistance rate to cefazolin( 100. 00%) and the lowest resistance rate to imipenem( 4. 65%) and meropenem( 4. 65%). Klebsiella pneumoniae had the highest resistance rate to ampicillin( 100. 00%) and the lowest resistance rate to meropenem( 5. 00%) and imipenem( 5. 00%). Escherichia coli had the highest resistance rate to ampicillin( 57. 30%)
and the lowest resistance rate to meropenem( 1. 12%) and imipenem( 1. 12%). Acinetobacter baumannii had the highest resistance rates to ampicillin( 100. 00%) and cefazolin( 100. 00%)
and the lowest resistance rate to meropenem( 54. 69%). Staphylococcus aureus had the highest resistance rate to penicillin( 100. 00%)
and the lowest resistance rate to nitrofurantoin( 0%)
tigecycline( 0%)
linezolid( 0%)
vancomycin( 0%) and levofloxacin( 0%). Streptococcus pneumoniae had the highest resistance rate to erythromycin( 100. 00%)
clindamycin( 100. 00%) and tetracycline( 100. 00%)
and the lowest resistance rate to oxacillin( 0%)
amoxicillin( 0%)
cefoxitin( 0%)
tobramycin( 0%)
rifampicin( 0%)
gentamicin( 0%)
ciprofloxacin( 0%)
teicoplanin( 0%)
vancomycin( 0%)
nitrofurantoin( 0%)
tigecycline( 0%)
linezolid( 0%)and levofloxacin( 0%). Candida albicans had the highest resistance rate to fluconazole( 20. 00%)
and the lowest resistance rate to voriconazole( 6. 67%). Candida glabrata had the highest resistance rate to fluconazole( 60. 00%) and itraconazole( 60. 00%)
and the lowest resistance rate to amphotericin B( 0%) and voriconazole( 0%). Candida tropicalis had the highest resistance rate to itraconazole( 66. 67%) and the lowest resistance rate to amphotericin B( 0%) and voriconazole( 0%). CONCLUSIONS: The lower respiratory tract infections in our hospital in the past 5 years were dominated by Gram-negative bacteria with high resistance to broad-spectrum penicillins and low resistance to carbapenems and compound preparations containing β-lactamase inhibitors. Clinical selection of antibiotics should be based on bacterial culture results and resistance rates
and individualized treatment protocols should be developed to improve the efficacy and curb the emergence of multi-drug resistant bacteria.
呼吸道感染细菌革兰阴性菌真菌抗菌药物耐药性
Respiratory tract infectionBacteriaGram-negative bacteriaFungiAntibioticsDrug resistance
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