目的 分析2020—2022年臨滄市人民醫(yī)院佤族患者下呼吸道標(biāo)本病原菌檢出情況及其耐藥率，為臨床合理治療佤族患者下呼吸道感染提供參考依據(jù)。方法 收集臨滄市人民醫(yī)院2020年1月—2022年12月送檢的佤族患者合格下呼吸道標(biāo)本進(jìn)行回顧性分析。結(jié)果 共檢出278株細(xì)菌，其中革蘭陰性細(xì)菌231株（占83.1%），革蘭陽性細(xì)菌47株（占16.9%）。肺炎克雷伯菌、大腸埃希菌、銅綠假單胞菌、金黃色葡萄球菌和嗜麥芽窄食單胞菌是佤族患者下呼吸道標(biāo)本最為常見的細(xì)菌。銅綠假單胞菌對常用抗假單胞菌藥物耐藥率均較低（＜10%），對亞胺培南的耐藥率為3.8%；嗜麥芽窄食單胞菌對米諾環(huán)素耐藥率達(dá)57.1%，對左氧氟沙星、復(fù)方磺胺甲唑無耐藥菌株。金黃色葡萄球菌對青霉素耐藥率為87.5%，耐甲氧西林金黃色葡萄球菌（MRSA）檢出率為12.5%，未檢出對萬古霉素和利奈唑胺耐藥的菌株；肺炎鏈球菌對青霉素耐藥率為0，對紅霉素、克林霉素和四環(huán)素耐藥率較高，均達(dá)81.8%。結(jié)論 臨滄市人民醫(yī)院佤族患者下呼吸道感染細(xì)菌以革蘭陰性桿菌為主。檢出的主要病原菌對臨床常用抗菌藥物的耐藥率低于其他研究，臨床治療時應(yīng)選擇適宜抗菌譜的藥物，同時及時進(jìn)行微生物學(xué)培養(yǎng)，根據(jù)藥敏試驗結(jié)果制定合理的藥物治療方案。

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

云南省哲學(xué)社會科學(xué)創(chuàng)新團(tuán)隊項目（2021tdxmy12）；臨滄市科技創(chuàng)新團(tuán)隊項目（202204AC100002-TD04）