目的 了解天津中医药大学第二附属医院下呼吸道感染病原菌的分布及细菌耐药情况,为临床合理用药提供依据。方法 对2015年天津中医药大学第二附属医院分离下呼吸道感染病原菌的分布及药敏结果进行回顾性分析。结果 共分离病原菌662株,其中革兰阴性菌504株,占76.13%;革兰阳性菌60株,占9.06%;真菌98株,占14.80%。主要革兰阴性菌对美罗培南的敏感率均达82%以上,不同的菌株对同种抗菌药物的敏感率不同;不论是革兰阴性菌还是革兰阳性菌普遍出现了多重耐药现象。白假丝酵母菌对两性霉素B、5-氟胞嘧啶、氟康唑、伊曲康唑和伏立康唑的敏感率均达到98%以上。结论 下呼吸道感染以革兰阴性菌为主,不同菌株对不同抗生素的耐药性也不同,临床应及时了解病原菌分布及耐药情况,合理使用抗菌药物。

Objective To understand the distribution and drug resistance analysis of pathogenic bacteria causing lower respiratory tract infection in Second Affiliated Hospital of Tianjin University of TCM, and to provide reference for clinical rational drug use. Methods The distribution and drug resistance analysis of pathogenic bacteria causing lower respiratory tract infection in Second Affiliated Hospital of Tianjin University of TCM in 2015 were analyzed retrospectively. Results Total 662 strains of pathogens were isolated, in which Gram-negative bacteria were 504 strains (76.13%). Gram-positive bacteria (60 strains) accounted for 9.06%. While there were also 98 strains of fungus (14.80%) isolated. The sensitive rate of main Gram-negative bacteria against meropenem was above 82%. Different bacteria had different sensitive rates against the same antibacterial drug. And Gram-negative bacteria and Gram-negative bacteria generally had the phenomenon of multiple drug resistance. The sensitive rates of Candida albicans against amphotericin B, 5-fluorocytosine, fluconazole, itraconazole, and voriconazole were above 98%. Conclusion The main pathogens causing lower respiratory tract infection is Gram-negative bacteria. The different drug resistance exists in different kinds of bacteria. The physician should understand local pathogenic bacteria distribution and drug resistance timely, in order to guide the clinical empirical use of antibacterial drugs.

国家科技重大专项课题(2012ZX09303010)