院内下呼吸道多重耐药菌感染的病原学及耐药特点分析
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摘要
目的探讨分析院内下呼吸道多重耐药菌感染的病原学及耐药特点。方法选取2017年2月～2018年2月收住本院并确诊为院内下呼吸道感染患者共98例,回顾性分析多重耐药菌的病原学分布及对常用抗菌药物的耐药性。结果 98例患者共培养出细菌菌株124株,其中革兰氏阴性菌79株(63.7%),革兰氏阳性菌45株(36.3%)。革兰氏阴性菌中较多的是铜绿假单胞菌(31株)、肺炎克雷伯菌(16株);革兰氏阳性菌中最多的是金黄色葡萄球菌21株。耐药情况显示,铜绿假单胞菌对莫西沙星耐药率较低(16.1%),肺炎克雷伯菌对亚胺培南耐药率较低(18.8),金黄色葡萄球菌对万古霉素无耐药。结论本院院内下呼吸道感染以革兰氏阴性杆菌为主,病原菌药敏分析显示多重耐药,治疗应结合药敏情况选择耐药性低的抗菌药物。
Objective To analysis the fectors of multiple drug-resistant bacteria on patients with lower respiratory tract infection. Methods The antimicrobial resistance of MDR bacteria were analyzed in 98 patients between Feb. 2017 and Feb. 2018. Results 124 strains of bacterial were fostered,including 79 Gram-negative strains(63.7%) and 45 Gram-positive ones(36.3%). The top two of negative ones were 31 strains of Pseudomonas aeruginosa(PA), 16 strains of Klebsiella pneumoniae(KP). The top one positive was 21 strains of Staphylococcus aureus(SA). It was showed that PA had a low resistance to moxifloxacin(16.1%), KP to imipenem(18.8%), and SA was not resistant to vancomycin. Conclusions The lower respiratory tract infection in our hospital was mainly gram negative bacilli, the treatment should be selecting antimicrobial drugs with low drug resistance.
Objective To analysis the fectors of multiple drug-resistant bacteria on patients with lower respiratory tract infection. Methods The antimicrobial resistance of MDR bacteria were analyzed in 98 patients between Feb. 2017 and Feb. 2018. Results 124 strains of bacterial were fostered,including 79 Gram-negative strains(63.7%) and 45 Gram-positive ones(36.3%). The top two of negative ones were 31 strains of Pseudomonas aeruginosa(PA), 16 strains of Klebsiella pneumoniae(KP). The top one positive was 21 strains of Staphylococcus aureus(SA). It was showed that PA had a low resistance to moxifloxacin(16.1%), KP to imipenem(18.8%), and SA was not resistant to vancomycin. Conclusions The lower respiratory tract infection in our hospital was mainly gram negative bacilli, the treatment should be selecting antimicrobial drugs with low drug resistance.
引文
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[2]杭景仙,魏群,宋艳梅,等.医院感染多重耐药菌变化趋势及耐药分析[J].中国药业,2018,27(6):93-95.
[3]中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.
[4]李春辉.MDR、XDR、PDR多重耐药菌暂行标准定义——国际专家建议[J].中国感染控制杂志,2014,13(1):62-64.
[5]韩茹,张志红.住院患者多重耐药菌的感染风险及耐药因素分析[J].临床合理用药杂志,2018,11(5):81-82.
[6]中华医学会呼吸病学分会感染学组.铜绿假单胞菌下呼吸道感染诊治专家共识[J].中华结核和呼吸杂志,2014,37(1):9-15.
[7]董燕,陈俊文,阳俊,王业亚.莫西沙星与头孢哌酮舒巴坦治疗老年心力衰竭患者铜绿假单胞菌院内感染的疗效对比观察[J].安徽医药,2018,22(2):312-315.
[8]农金轻,赵晓丽,谷依林,等.1916株连续分离的肺炎克雷伯菌临床分布及耐药性变迁[J].中国医药科学,2018,8(1):17-21.