陈文台

[摘要] 目的 了解本院重症监护室住院患者呼吸系统感染的常见病原茵分布及对药物的敏感情况，指导临床合理用药。 方法 回顾性分析2014年1～12月310例痰标本细菌培养和药敏试验结果。 结果 310例痰标本中检出158株细菌，阳性率为54.2%，其中革兰氏阴性杆菌86株，占54.4%；革兰氏阳性球菌13株，占8.2%；真菌59株，占37.4%。药敏结果显示，氨基糖苷类及碳青酶烯类对革兰氏阴性杆茵抗菌作用较强，葡萄球菌对青霉素耐药率较高，金黄色葡萄球菌耐药率为96.3%，溶血葡萄球菌耐药率为100.0%。 结论 革兰氏阴性杆菌、真菌感染不容忽视，临床应根据病原菌种类、药敏试验结果正确选择抗菌药物。

[关键词] 痰培养；病原茵；药敏

[中图分类号] R181.3+4 [文献标识码] A [文章编号] 1674-4721（2015）08（c）-0126-03

[Abstract] Objective To get known the common pathogenic bacteria distribution in patients with respiratory system infection and drug sensitivity in intensive care unit（ICU），and aim at guiding the rational drug usage in clinic. Methods From January to December 2014，outcomes of 310 sputum specimens bacterial culture and drug sensitive test were retrospectively analyzed. Results One hundred and fifty-eight strains of bacteria were detected from all sputum specimens，and the positive rate was 54.2%.There were 86 strains of gram-negative bacilli accounting for 54.4%.The gram-positive coccus was 13 strains for 8.2%，and 59 strains in fungus for 37.4%.Outcomes of drug sensitive test displayed aminoglycosides and carbapenms had strong effects on resisting gram-negative bacilli.Staphylococcus had a high drug resistance rate on penicillin，and the drug resistance rate of staphylococcus aureus was 96.3% and the resistance rate was 100.0% in staphylococcus haemolyticus. Conclusion Infection of gram-negative bacilli and fungus cannot be neglected.Correct selection of antibacterial agents should be based on pathogenic species and outcome of drug sensitive test.

[Key words] Sputum culture；Pathogenic bacterium；Drug sensitivity

肺部感染为重症病房最为常见的临床疾病，随着抗菌药物的广泛应用，引起肺部感染的常见病原茵的种类及对药物的敏感度不断发生变化，许多研究表明，重症监护室（ICU）菌株对抗生素耐药性呈不断上升趋势[1-3]，为有效控制感染并掌握肺部感染病原菌种类分布，本文对本院ICU310例痰标本进行培养并进行药敏分析。

1 资料与方法

1.1 一般资料

选取2014年1～12月本院ICU住院患者310例。标本取材：患者晨起后以生理盐水漱口或口腔护理及经吸痰管、纤维支气管镜从人工自气道吸引下呼吸道分泌物至无菌容器中，30 min内送检。同一病例的相同菌种标本，若同一周内，则视为同一菌株，不重复统计。

1.2 培养方法

采用微量生化管进行鉴定分析，微量生化管和培养基均购自杭州天和微生物试剂有限公司。……