下呼吸道感染, 微生物学,耐药性,细菌," /> 下呼吸道感染, 微生物学,耐药性,细菌,"/> Lower respiratory tract infection, Microbiology, Drug resistance, Bacteria,"/> <span style="line-height:2;font-size:14px;">下呼吸道感染革兰阴性杆菌分布及</span><span style="line-height:2;font-size:14px;">耐药分析</span>
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发育医学电子杂志  2013, Vol. 1 Issue (4): 201-204    
  发育基础   论著 |
下呼吸道感染革兰阴性杆菌分布及耐药分析
郭婧 高鸿敏  
北京军区总医院263临床部
Distribution and drug resistance analysis of Gram-negative bacteria in lower respiratory atract infections
GUO Jing,GAO Hong-min
263 Clinical Department of the Military General Hospital of Beijing PLA
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摘要 【摘要】 目的 分析呼吸内科下呼吸道感染住院患者革兰阴性杆菌分布及耐药性变化情况,为临床合理用药提供依据。方法 分析2010 年11 月至2011 年11 月我院呼吸内科下呼吸道感染患者痰标本分离出的176 株革兰阴性菌及耐药情况。结果 我院呼吸科病房主要致病的革兰阴性菌依次为铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌、嗜麦芽窄食单胞菌、阴沟肠杆菌等;52 株铜绿假单胞菌中对左氧氟沙星、哌拉西林/ 舒巴坦耐药率分别为21.1% 和21.4% ;对美罗培南、亚胺培南的耐药率分别为38.2%、48.9% ;对阿米卡星、头孢哌酮/ 舒巴坦、头孢吡肟、头孢他啶、氨曲南等耐药率在26.0% ~ 45.0%,对氨苄西林、氨苄西林/ 舒巴坦、其他头孢类测试药物的耐药率均在80% 以上。21 株鲍曼不动杆菌对所测试药物均显示较高耐药性,除阿米卡星及哌拉西林/ 他唑巴坦相对较低外,对美罗培南及亚胺培南耐药率达到42.4% 和50.0%,对氨苄西林和一代头孢、二代头孢耐药率接近100%。嗜麦芽窄食单胞菌对左氧氟沙星、复方新诺明耐药率分别为27.3%、14.3%,对米诺环素仍呈敏感;大肠埃希菌和肺炎克雷伯菌ESBLs 的总检出率分别为72.7% 和16.6%,大肠埃希菌产ESBLs 株对庆大霉素、环丙沙星、左氧氟沙星及大多数B 内酰胺酶类药物的耐药率在90.0% 以上。肠杆菌科细菌中不同菌种对碳青霉烯类、哌拉西林他唑巴坦敏感率100%。结论 革兰阴性菌是呼吸内科病房内感染的主要致病菌, 对各种抗生素均呈不同程度耐药, 为控制耐药菌株的产生和扩散,抗生素的合理使用和细菌耐药性的监测尤为重要。
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关键词:  下呼吸道感染')" href="#">下呼吸道感染  微生物学  耐药性  细菌    
Abstract: 【Abstract】 Objectives To provide the evidence for treatment to lower respiratory tract infections, a study on distribution and drug resistance analysis of Gram-negative bacteria was conducted in the department of respiratory. Methods Sputum samples were collected from inpatients with lower respiratory tract infections in department of respiratory of our hospital from November 2010 to November 2011. Gram-negative bacteria from these samples was isolated, then the distribution and drug resistance analysis of these bacteria was conducted. Results In respiratory ward of our hospital, the main pathogenic Gram-negative bacteria were Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, maltophilia Aeromonas, Enterobacter cloacae, etc. Of the 52 specimens were positive for Pseudomonas aeruginosa,levofloxacin, piperacillin / sulbactam resistance rates were 21.1% and 21.4%, respectively, Resistance rate to meropenem, imipenem were 38.2%, 48.9%; amikacin, cefoperazone / sulbactam, cefepime, ceftazidime, aztreonam resistance rate at 26.0% -45.0%, ampicillin, ampicillin / sulbactam, other cephalosporin resistance rates of drug testing in more than 80%.21 Acinetobacter baumannii tested for drugs showed high resistance, in addition to amikacin and piperacillin / tazobactam is relatively low, the meropenem and imipenem were 42.4% and 50.0%, ampicillin,and generation cephalosporins, second-generation cephalosporin resistance were close to 100%. Maltophilia Aeromonas levofloxacin, cotrimoxazole resistance rates were 27.3%, 14.3%, respectively, continued to show
sensitivity to minocycline. Escherichia coli and Klebsiella pneumoniae ESBL s overall detection rate was 72.7% and 16.6%, respectively, of the E. coli strains producing ESBLs gentamicin, ciprofloxacin, levofloxacin, and most B amide enzymes of drug resistance rates above 90%. Different strains of Enterobacteriaceae to carbapenems, piperacillin tazobactam rate of 100%.Conclusion Gram-negative bacteria were major pathogens in the respiratory ward, They showed varying degrees of resistance to various antibiotics. To control the generation and spread of resistant strains, the rational use of antibiotics and bacterial resistance surveillance were important.
Key words:  Lower respiratory tract infection')" href="#">Lower respiratory tract infection    Microbiology    Drug resistance    Bacteria
收稿日期:  2013-10-10                出版日期:  2013-10-30      发布日期:  2019-07-22      期的出版日期:  2013-10-30
通讯作者:  高鸿敏    E-mail:  gaohongmin1975@126.com
引用本文:    
郭婧 高鸿敏. 下呼吸道感染革兰阴性杆菌分布及耐药分析[J]. 发育医学电子杂志, 2013, 1(4): 201-204.
GUO Jing, GAO Hong-min. Distribution and drug resistance analysis of Gram-negative bacteria in lower respiratory atract infections. Journal of Developmental Medicine(Electronic Version), 2013, 1(4): 201-204.
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