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目的了解2014年我院呼吸内科下呼吸道感染住院患者痰标本病原菌分布情况及耐药特征。方法收集2014年1~12月,我院呼吸内科住院部收治的下呼吸道感染患者1008例进行痰液标本检验,分析标本中病原菌的构成情况及主要几种致病菌对常用抗菌药的耐药率。结果 1008名患者送检标本共分离得到病原菌468份,检出率为46.4%。其中,分离出革兰阴性菌307株(65.60%),革兰阳性菌127株(27.14%),真菌34株(7.26%)。在分离的革兰阴性菌中,所占构成比最高为铜绿假单胞菌(97株,20.73%),其次为肺炎克雷伯菌72株(15.38%);革兰阳性菌中所占比例最大的为肺炎链球菌57株(12.18%),其次为金黄色葡萄球菌31株(6.62%);真菌共检出34株(7.26%),白假丝酵母菌在真菌中所占比例最大(3.48%)。结论下呼吸道感染的住院患者中,革兰阴性菌感染所占比例较高,铜绿假单胞菌是革兰阴性菌中的主要致病菌。致病菌的耐药率较高,对各类药物的耐药率不尽相同,临床应根据药敏实验结果合理使用抗菌药。
Objective To understand the distribution and drug resistance of sputum specimens in hospitalized patients with respiratory tract infection of lower respiratory tract in our hospital in 2014. Methods From January to December 2014, 1008 cases of lower respiratory tract infection admitted to Department of Respiratory Medicine and Inpatient Department of our hospital were collected for sputum sample analysis. The composition of the pathogens and the resistance of several pathogens to commonly used antibiotics rate. Results A total of 468 pathogens were isolated from 1008 patients and the detection rate was 46.4%. Among them, 307 strains (65.60%) of gram-negative bacteria, 127 strains (27.14%) of gram-positive bacteria and 34 strains (7.26%) of fungi were isolated. Among the isolates of Gram-negative bacteria, the highest constituent ratio was Pseudomonas aeruginosa (97 strains, 20.73%), followed by 72 strains (15.38%) of Klebsiella pneumoniae; the proportion of Gram-positive bacteria 57 (12.18%) were the most common strains of Streptococcus pneumoniae, 31 were Staphylococcus aureus (6.62%), 34 (7.26%) were fungi and Candida albicans was the most common in fungi 3.48%). Conclusion Among the hospitalized patients with lower respiratory tract infection, Gram-negative bacteria account for a higher proportion of infections. Pseudomonas aeruginosa is the main pathogen in Gram-negative bacteria. The rate of high resistance to pathogens, drug resistance rates for all types of drugs are not the same, the clinical application of antimicrobial agents should be based on the results of susceptibility testing.