北京市某医院下呼吸道感染患者分离病原菌的多样性及多重耐药性分析
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摘要
目的了解某医院下呼吸道感染患者痰标本分离病原菌的多样性及多重耐药性。方法对2015年11月-2016年8月下呼吸道感染患者的痰标本进行病原菌采集及分离培养,鉴定病原菌种类及药敏分析。结果从162例下呼吸道感染患者的痰标本中分离35种非重复病原菌226株,其中37例患者分别分离出2～5种病原菌。男性患者菌株分离数量高于女性;病原菌多样性>60岁患者较高,医院获得性下呼吸道感染患者显著高于社区患者。呼吸内科、空勤干部科和消化肿瘤科患者分离的病原菌多样性居前3位。结论不同年龄和感染类型的下呼吸道感染患者痰标本的病原菌多样性均有显著差异;患者痰标本的病原菌多样性和多重耐药率不同科室均有显著差异。
Objective To investigate the diversity and multi-drug resistance of pathogenic bacteria isolated from sputum specimens of patients with lower respiratory tract infection in a hospital. Methods Sputum specimens from patients with lower respiratory tract infection from November 2105 to August 2016 were collected to isolate pathogenic bacteria. Identification and drug sensitivity analysis of isolated pathogens were detected. Results A total of 226 non-repeated pathogens( 35 species) were isolated from 162 cases of lower respiratory tract infection,and 2-5 species of pathogens were detected from37 cases respectively. The number of isolated strains in male patients was significantly higher than that in female patients.The diversity of pathogenic bacteria of patients over 60 years old was significantly higher,and patients with hospital lower respiratory tract infection was significantly higher than that of patients with community-acquired lower respiratory tract infection. Departments of respiratory medicine,air force cadre and digestive oncology rank the top 3 in the diversity of pathogenic bacteria. Conclusion There are significant differences in the pathogen diversity of sputum samples from patients of different ages and types of infection. The pathogen diversity and multi-drug resistance rate of sputum samples from different departments are significantly different.
Objective To investigate the diversity and multi-drug resistance of pathogenic bacteria isolated from sputum specimens of patients with lower respiratory tract infection in a hospital. Methods Sputum specimens from patients with lower respiratory tract infection from November 2105 to August 2016 were collected to isolate pathogenic bacteria. Identification and drug sensitivity analysis of isolated pathogens were detected. Results A total of 226 non-repeated pathogens( 35 species) were isolated from 162 cases of lower respiratory tract infection,and 2-5 species of pathogens were detected from37 cases respectively. The number of isolated strains in male patients was significantly higher than that in female patients.The diversity of pathogenic bacteria of patients over 60 years old was significantly higher,and patients with hospital lower respiratory tract infection was significantly higher than that of patients with community-acquired lower respiratory tract infection. Departments of respiratory medicine,air force cadre and digestive oncology rank the top 3 in the diversity of pathogenic bacteria. Conclusion There are significant differences in the pathogen diversity of sputum samples from patients of different ages and types of infection. The pathogen diversity and multi-drug resistance rate of sputum samples from different departments are significantly different.
引文
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[15]万秋斌,张凤勇,范萃,等. ICU患者下呼吸道标本中鲍曼不动杆菌的耐药性分析[J].国际检验医学杂志,2017,38(5):649-650,653.
[16]王亚丽,吴峰,胡锋,等.多重耐药鲍曼不动杆菌下呼吸道感染的临床特点及药敏分析[J].临床肺科杂志,2017,22(3):479-483.
[17]陈宏斌,赵春江,王辉,等. 2007-2013年医院内获得性肺炎病原菌分布及其耐药性分析[J].中华医院感染学杂志,2017,27(1):1-7,15.
[2]袁欢欢,李元叶,孙春燕.某院住院患者医院感染和社区感染横断面调查[J],中国感染控制杂志,2017,16(3):267-269.
[3]杨锦弥.呼吸重症监护病房重症下呼吸道感染抗菌药物的降阶梯治疗[J],中国继续医学教育,2018,10(1):98-99.
[4]徐苗苗,于树云.呼吸科下呼吸道感染革兰阴性菌耐药性分析[J].中外医学研究,2017,15(1):48-50.
[5]吴传湘,周康仕.老年人下呼吸道感染病原菌及耐药性分析[J],中国处方用药,2018,16(1):44-45.
[6] Wang M,Jiang P. Colonization and diversity of AM fungi by morphological analysis on medicinal plants in southeast China[J].The Scientific World J,2015:753842.
[7] Johansen PO,Isaksen TE,Bye-Ingebrigtsen E,et al. Temporal changes in benthic macrofauna on the west coast of Norway resulting from human activities[J]. Mar Pollut Bull,2018,128:483-495.
[8]尚红,王毓三,申子瑜.全国临床检验操作规程[M].第4版.北京:人民卫生出版社,2015.
[9]黄勋,邓子德,倪语星,等.多重耐药菌医院感染预防与控制中国专家共识[J].中国感染控制杂志,2015,14(1):1-9.
[10]张秀红,李朗,董亮,等.重症医学科2613株下呼吸道病原体分布及耐药性[J].中国感染控制杂志,2016,15(12):917-920.
[11]胡华军,姚燕.重型颅脑外伤患者下呼吸道感染病原菌分布特点与耐药性分析[J].中国消毒学杂志,2017,34(5):459-461.
[12] Vijay S,Dalela G. Prevalence of LRTI in patients presenting with productive cough and their antibiotic resistance pattern[J]. J Clin Diagn Res,2016,10(1):DC09-DC12.
[13] Szeto GN,Yang Y,Kwan JKC,et al. Effects of Surface Material,Ventilation,and Human Behavior on Indirect Contact Transmission Risk of Respiratory Infection[J]. Risk Anal,2014,34(5):818-830.
[14]牛文凯,郑敬,翟宏岩,等,某三甲综合医院呼吸内科下呼吸道感染调查分析[J].临床肺科学杂志,2016,21(11),1983-1986.
[15]万秋斌,张凤勇,范萃,等. ICU患者下呼吸道标本中鲍曼不动杆菌的耐药性分析[J].国际检验医学杂志,2017,38(5):649-650,653.
[16]王亚丽,吴峰,胡锋,等.多重耐药鲍曼不动杆菌下呼吸道感染的临床特点及药敏分析[J].临床肺科杂志,2017,22(3):479-483.
[17]陈宏斌,赵春江,王辉,等. 2007-2013年医院内获得性肺炎病原菌分布及其耐药性分析[J].中华医院感染学杂志,2017,27(1):1-7,15.