目的 分析2020—2022年临沧市人民医院佤族患者下呼吸道标本病原菌检出情况及其耐药率，为临床合理治疗佤族患者下呼吸道感染提供参考依据。方法 收集临沧市人民医院2020年1月—2022年12月送检的佤族患者合格下呼吸道标本进行回顾性分析。结果 共检出278株细菌，其中革兰阴性细菌231株（占83.1%），革兰阳性细菌47株（占16.9%）。肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌和嗜麦芽窄食单胞菌是佤族患者下呼吸道标本最为常见的细菌。铜绿假单胞菌对常用抗假单胞菌药物耐药率均较低（＜10%），对亚胺培南的耐药率为3.8%；嗜麦芽窄食单胞菌对米诺环素耐药率达57.1%，对左氧氟沙星、复方磺胺甲唑无耐药菌株。金黄色葡萄球菌对青霉素耐药率为87.5%，耐甲氧西林金黄色葡萄球菌（MRSA）检出率为12.5%，未检出对万古霉素和利奈唑胺耐药的菌株；肺炎链球菌对青霉素耐药率为0，对红霉素、克林霉素和四环素耐药率较高，均达81.8%。结论 临沧市人民医院佤族患者下呼吸道感染细菌以革兰阴性杆菌为主。检出的主要病原菌对临床常用抗菌药物的耐药率低于其他研究，临床治疗时应选择适宜抗菌谱的药物，同时及时进行微生物学培养，根据药敏试验结果制定合理的药物治疗方案。

Objective To analyze the detection and drug resistance rate of pathogens in lower respiratory tract specimens of Wa nationality patients in The People’s Hospital of Lincang from 2020 to 2021, so as to provide reference basis for clinical rational treatment of lower respiratory tract infection in Wa nationality patients. Methods The data of strains isolated from lower respiratory tract specimens of Wa nationality patients in The People’s Hospital of Lincang from January 1, 2020 to December 31, 2022 were collected analyzed. Results A total of 278 strains of bacteria were detected, among them, gram-negative bacteria accounted for 231 strains (83.1%) and gram-positive bacteria accounted for 47 strains (16.9%). Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Stenotrophomonas maltophilia were the most common bacteria in lower respiratory tract samples of Wa nationality patients. The resistance rate of P.aeruginosa to common anti-pseudomonas drugs was low (< 10%), and the resistance rate of imipenem was 3.8%. The resistance rate of S.maltophilia to minocycline was 57.1%, and there was no resistance to levofloxacin and compound sulfamethoxazole. The resistance rate of S.aureus to penicillin was 87.5%, and the detection rate of methicillin-resistant S.aureus (MRSA) was 12.5%. No strains resistant to vancomycin and linezolid were detected. The resistance rate of S.pneumoniae to penicillin was 0, and the resistance rate of S.pneumoniae to erythromycin, clindamycin, and tetracycline was 81.8%. Conclusion Gram-negative bacilli predominate in the lower respiratory tract infection of Wa nationality patients of The People’s Hospital of Lincang. The resistance of the main pathogenic bacteria detected to commonly used clinical antibiotics is lower than other studies. In clinical empirical treatment, drugs with appropriate antibacterial spectrum should be selected, and microbiological culture should be carried out in a timely manner. According to the results of drug sensitivity test, a reasonable drug treatment plan was formulated.

R978.1

云南省哲学社会科学创新团队项目（2021tdxmy12）；临沧市科技创新团队项目（202204AC100002-TD04）