目的: 研究下呼吸道所感染病原菌的分布以及耐药状况，给临床治疗下呼吸道感染性疾病提供参考
依据，并且可以指导临床合理使用抗菌药物。方法: 对诊断为下呼吸道感染病人的深部痰液进行培养，共培养分
离出3936 株致病菌，对其鉴定及药物敏感试验的结果进行了回顾性分析。结果: 下呼吸道感染病原菌中鲍曼不
动杆菌检出率最高为905 株( 23%) ，其次为肺炎克雷伯菌818 株( 20．8%) 、铜绿假单胞菌768 株( 19．5%) 、金黄
色葡萄球菌405 株( 10．3%) 、大肠埃希菌350 株( 8．9%) ; 对亚胺培南的耐药率: 大肠埃希菌最低为0．1%，肺炎克
雷伯菌为0．3%。鲍曼不动杆菌和铜绿假单胞菌的耐药率较高，未发现耐万古霉素金黄色葡萄球菌。结论: 下呼
吸道感染主要病原菌为鲍曼不动杆菌和肺炎克雷伯菌，对头孢类和喹诺酮类药物的耐药率明显较高，临床应依
据药敏报告结果合理选用抗菌药物。

Objective: Explore the distribution of lower respiratory tract infection pathogens and
drug resistance status， for the treatment of lower respiratory tract infection provide reliable evidence to
guide clinical use of drugs Methods: The lower respiratory infection in patients with isolated sputum
culture and sensitivity test of 3936 pathogens were retrospectively analyzed．Results: Lower respiratory
tract infections of Acinetobacter baumannii isolated in the highest detection rate， for 905( 23%) ， followed
by Klebsiella pneumoniae 818( 20．8%) ，Pseudomonas aeruginosa 768( 19．5%) ，Staphylococcus
aureus 405( 10．3%) ，Escherichia coli 350( 8．9%) ．To imipenem resistance rate as low as 0．1%、Escherichia
coli and Klebsiella pneumoniae 0．3%，Acinetobacter baumannii and Pseudomonas aeruginosa
resistance to a higher rate and found no resistance to vancomycin Staphylococcus aureus．Conclusion:
The main pathogens of lower respiratory tract infections of Acinetobacter baumannii and Klebsiella
pneumoniae， to cephalosporins and quinolones significantly higher rates of drug resistance，clinical drug
sensitivity results of the report should be based on reasonable selection of antimicrobial agents．

R563．1

 收稿日期: 2017－03－05; 修回日期: 2017－06－05
基金项目: 内蒙古自治区自然基金立项资助课题( 2013MS11113)
作者简介: 燕成岭( 1962－) ，男，内蒙古自治区人民医院检验科主任检验师。