摘要
目的:了解下呼吸道感染病原体的流行情况、主要流行病原体的耐药现状以及一些特殊病原体[如耐甲氧西林的葡萄球菌(MRS)、超广谱β-内酰胺酶(ESBLs)菌株等]的流行和耐药现状,为临床合理应用抗菌药物提供依据。方法:用WHONET5软件统计分析2004年南京医科大学第一附属医院住院患者3863份痰液标本培养及药敏结果。结果:下呼吸道感染病原体中,革兰阴性菌居首位,占所有阳性标本的50%;其次为真菌占33%。所有致病菌中,白色念珠菌位居第一(14%),铜绿假单胞菌位居其次(11%),不动杆菌属(8%)、肺炎克雷伯菌(8%)、热带念珠菌(7%)亦较为常见,耐药菌株比例较高。产ESBLs菌检出率为12%,对三、四代头孢菌素及氟喹诺酮类耐药比例较高。MRS占所有葡萄球菌的65%,以表皮葡萄球菌为主,对大环内酯类、氟喹诺酮类及头孢菌素类呈现高度耐药。结论:目前下呼吸道感染病原体中条件致病菌比例在逐年上升,多药耐药菌比例增加。针对产ESBLs菌株建议选用碳青霉烯类、哌拉西林/他唑巴坦,对MRS推荐用万古霉素,其他药物耐药率均较高。
Objective： To investigate the status of common and special pathogens in low respiratory tract infection, such as MRS and ESBLs producing strains, and their drug resistance in order to provide evidence for clinical therapy. Methods： The cultured results of 3 863 sputum specimens isolated from inpatients during the whole year 2004 and the drug susceptibility of pathogens were analyzed by the software WHONETS. Results： During all pathogens, Gram-negative bacteria accounted for 50% while fungi accounted for 33%. candida albicans accounted for 14%, pseudomonas aeruginosa 11%, klebsieUa pneumoniae 8%, acinetobacter sp 8% and candida tropicalis 7%. Bacteria producing extended-spectrum beta-lactamase （ESBLs） accounted for 12% which had high resistance to third and forth generation cephalosporins and fluoroquinolones. Methicillin-resistant staphylococcus （MRS） accounted for 65% of all staphylococcus, resisting significantly to macrolides, cephalosporins and fluoroquinolones. Conclusion： At present, The percentage of opportunistic pathogens and muhidrug resistant pathogens in low respiratory tract infection increases with time. Carbopenems and piperacillin/tazobactam were recommended for ESBLs-producing pathogens and Vancomycin for MRS.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2006年第1期29-32,共4页
Journal of Nanjing Medical University(Natural Sciences)
