下呼吸道感染革兰氏阴性杆菌分布与耐药性分析

摘要

目的 分析下呼吸道感染痰液标本分离出革兰氏阴性杆菌的分布及对常用抗生素的耐药性,为临床合理用药提供参考依据.方法 对西安市第一医院2010年1～12月分离出的非重复562株革兰氏阴性杆菌利用VITEK 2 COMPACT进行病原学鉴定和药敏试验.采用WHONET5.0版软件统计分析数据.结果 562株革兰氏阴性杆菌前四位依次为肺炎克雷伯氏菌,铜绿假单胞菌,大肠埃希氏菌和鲍氏不动杆菌.药敏结果显示大肠埃希氏菌、铜绿假单胞菌和鲍氏不动杆菌对常用抗生素的耐药率较高.结论 老年病科常见革兰氏阴性杆菌对常用抗生素的耐药性最为严重,其次为呼吸科.临床应根据药敏试验结果合理选用抗生素,以减少耐药菌株的产生和传播,有效控制医院感染.%Objective To investigated the distribution and resistance to commonly used antibiotics of Gram-negative bacilli in lower respiratory tract infections in the First hospital of Xi'an.to provide the basis fact for rational clinical application of antibiotics. Methods Using aetiology and drug sensitivity methods to analyse 562 Gram-negative bacilli which isolated from 2 119 sputum sample in the period of Jan to Dec 2010 in the First Hospital of Xi'an. WHONET 5.0 statistic software was used to analyse the data. Results The top four Gram-negative bacilli were Klebsiella pneumoniae, Pseudomonas aerug-inosa,Escherichia coli and Acinetobacter Baumannii. The results of drug sensitivity test showed that the resistance of Es-cherichia coli rPseudomonas aeruginosa and Acinetobacter Baumannii to commonly used antibiotics were high. Conclusion The resistance of common Gram-negative bacilli to commonly used antibiotics was the most serious in department of geriatrics in the hospital. Department of respiration was less than it. It was important to reduce the generation and dissemination of resistant strains and to control of hospital infection by rational use of antibiotics according to the results of drug sensitivity test.