下呼吸道感染患者分离的革兰阴性菌8年资料分析
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王天立

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R969.3

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Gramnegative bacteria isolated from patients with lower respiratory tract infection:a 8year data analysis
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    摘要:

    目的了解某院下呼吸道革兰阴性(G-)菌感染者的病原菌分布及其耐药情况,为临床抗感染治疗提供依据。方法回顾性分析2002年1月—2009年12月8年间该院住院的下呼吸道感染患者痰液及支气管吸取物、胸腔积液标本细菌培养及药敏试验结果。结果8年共分离病原菌9 884株,其中G-菌6 358株(64.33%)。构成比居前列的G-菌为铜绿假单胞菌(33.41%)、不动杆菌属(20.51%)、克雷伯菌属(19.11%)、大肠埃希菌(12.65%)等。2008—2009年主要肠杆菌科细菌对碳青霉烯类药物美罗培南、亚胺培南耐药率低(<3%),耐药率相对较低的抗菌药物有阿米卡星(17.37%~19.58%)、头孢哌酮/舒巴坦(10.67%~23.62%)、哌拉西林/他唑巴坦(13.58%~25.11%)等;铜绿假单胞菌对碳青霉烯类抗生素的耐药率已高达38.54%,耐药率相对较低的抗生素有阿米卡星(31.50%)及米诺环素(32.00%);不动杆菌属耐药率较低的抗菌药物有碳青霉烯类(10.47%)、左氧氟沙星(24.64%)、阿莫西林/克拉维酸(24.33%)、头孢哌酮/舒巴坦(27.00%)及米诺环素(10.27%)。结论G-菌为该地区下呼吸道感染的主要病原菌,分离率居前列的G-菌对大多数抗菌药物的耐药性不断升高,应加强监测。

    Abstract:

    ObjectiveTo understand the distribution and drugresistance of gramnegative bactera isolated from lower respiratory tract in a hospital , so as to provide reference for antiinfection treatment in clinic.MethodsBacteria were isolated from sputum, bronchial aspiration,and pleural effusion of patients  admitted in  a hospital from January 2002 to December 2009, distribution and drug susceptibility test of bacteria  were analysed retrospectively.ResultsA total of 9 884 isolates of bacteria were isolated during 8 years, 6 358 (64.33%) of which were gramnegative bacteria . The main isolated bacteria were Pseudomonas aeruginosa(33.41%), Acinetobacter spp. (20.51%), Klebsiella spp.(19.11%) , and Escherichia coli(12.65%) . The main bacteria of Enterobacteriaceae had low resistance to carbapenems,such as meropenem and imipenem (<3%), and had relative lower resistance to amikacin(17.37%-19.58%), cefoperazone/sulbactam (10.67%-23.62%) , and piperacillin/tazobactam(13.58%-25.11%). The resistant rate of Pseudomonas aeruginosa to  carbapenems was up to 38.54% , and had relatively lower resistance to amikacin(31.50%) and minocycline(32.00%); Acinetobacter spp. had relatively lower resistance to  carbapenems(10.47%), levofloxacin (24.64%) ,amoxicillin/clavulanic acid (24.33%), cefoperazone/sulbactam (27.00%) ,and minocycline(10.27%).ConclusionGramnegative bacteria are the major pathogens in lower respiratory tract infection  in this area, the main isolated bacteria have a rising resistance to most antimicrobial agents.

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引用本文

裴文军,王天立,杨泽刚.下呼吸道感染患者分离的革兰阴性菌8年资料分析[J]. 中国感染控制杂志,2011,10(2):105-108.
PEI Wenjun, WANG Tianli, YANG Zegang. Gramnegative bacteria isolated from patients with lower respiratory tract infection:a 8year data analysis[J]. Chin J Infect Control, 2011,10(2):105-108.

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  • 收稿日期:2010-09-27
  • 最后修改日期:2010-11-05
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  • 在线发布日期: 2011-03-30
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