【摘要】 目的了解2008年我院呼吸病房下呼吸道感染中G-菌(革兰阴性菌)的分布及药敏试验,为合理应用抗菌药物提供依据。方法对我院呼吸病房2008年住院患者的合格呼吸道分泌物进行细菌培养,分析G-菌的体外药敏试验情况。结果共分离到363株致病菌,其中G-菌189株。常见病原菌依次为铜绿假单胞菌,肺炎克雷伯菌,大肠埃希菌,嗜麦芽窄食单胞菌。铜绿假单胞菌对阿米卡星等敏感率为61%～87%,嗜麦芽窄食单胞菌对左氧氟沙星、复方新诺明的敏感率为94.7%,肺炎克雷伯菌对亚胺培南等敏感率为61.5%～94.2%,产ESBL株的检出率为21.2%。大肠埃希菌对阿米卡星、亚胺培南的敏感率为100%,产ESBL株的检出率30%。结论下呼吸道G-菌感染中,最常见为铜绿假单胞菌。铜绿假单胞菌的治疗可选用碳青酶烯类或+氟喹诺酮类或氨基糖苷类;复方新诺明和左氧氟沙星可作为嗜麦芽窄食单胞菌感染的首选药物;肺炎克雷伯菌、大肠埃希菌的治疗可首选碳青酶烯类或阿米卡星。更多还原

【Abstract】 Objective To investigate the distribution and drug sensitivity of gram-negative bacteria in patients with lower respiratory tract infection in the respiratory division of our hospital in 2008,and to offer evidence for utilizing antibacterials reasonably.Method The qualified sputum samples from inpatients with the lower respiratory infection in the first Affiliated Hospital of Anhui Medical university in 2008 were detected with bacteriological culture,and we analyze drug sensitive of the gram-negative bacteria.Test method and drug sensitive judgment were in accordance with National Committee for Clinical Laboratory Standards.Resluts 363 strains of pathogenic bacterium were isolated,and 189 strains were gram-negative bacteria.The most common pathogens were Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,stenotrophomonas maltophilia.Pseudomonas aeruginosa was sensitive to amikacin ect(61%~87%).The drug sensitive ratio of stenotrophomonas maltophilia to Levofloxacin and Bactrim was 94.7%.Klebsiella pneumoniae was sensitive to Imipenem ect(61.5%~94.2%),the prevalence of extended-spectrum B-lactamases(ESBLs) in Klebsiella pneumoniae was 21.2%.The drug sensitive rate of Escherichia coli to Amikacin and Imipenem was 100% and to Cefoperazone and Sulbactam was 95%.Resistance rate of Escherichia coli to lactam antibiotics was high.The prevalence of ESBLs in Klebsiella pneumoniae was 30%.Conclusion The most common pathogen of lower respiratory infection was Pseudomonas aeruginosa.To treat Pseudomonas aeruginosa can use carbopenems or with FQNS or Ciprofloxacin.Bactrim and Levofloxacin can be used firstly to treat stenotrophomonas maltophilia.To treat Klebsiella pneumoniae or Escherichia coli can use carbopenems or Amikacin.更多还原