187例难治性肺部感染的细菌学分析及治疗对策  

Analysis and treating strategy on drug resistance to antibiotics of pathogenic bacteria of refractory pulmonary lnfection

作　　者：陈昌碧[1] 崔社怀[2] 

机构地区：[1]重庆市中山医院呼吸内科,400013 [2]第三军大学大坪医院呼吸科,重庆400010

出　　处：《重庆医学》2006年第8期710-711,713,共3页Chongqing medicine

摘　　要：目的 分析难治性细菌性肺部感染的病原菌和药敏试验及临床治疗结果。方法 对2002年1月-2005年6月间难治性细菌性肺部感染患者，采用北京红祥聚科贸有限公司出品一次性使用痰液收集器，采集下呼吸道标本进行培养和药敏试验。结果 共培养细菌116株，革兰阴性杆菌（GMB）90株（82．8％）；革兰阳性球菌（GPC）20株（7．2％）。主要是铜绿假单胞菌、恶臭假单胞菌、肺炎克雷伯菌和金黄色葡萄球菌，病原菌广泛耐性。结论 引起难治性肺部感染的病原菌中以耐药假单胞菌、肺炎克雷伯菌 、金黄色葡萄球菌为主。临床上特别重视病原学诊断及治疗原则。Objective To investigate the pathogenic bacteria,drug resistance to antibiotics and treatment of clinical refractory pulmonary infection. Methods From Jan. 2002 to Jun. 2005,187 cases of refractory pulmonary infection were investigated retrospectively. The pathogenic bacteria and drug resistance in sputum culture during hospitalization were analysed. Samples from refractory lung infection in 187 cases were isolated,identified by API. Drug sensitivity was tested with ATB-test paper. Results 82. 8% of Gram negative bacilli（90 strains） were the predominant pathogens. The main organisms were Pseudomonas aeruginosa and Klebsiella species. 7.2% of the Gram-positive cocci （20 strains） were staphylococcus aureus which were resistant to methicillin. The other bacteria had high resistance rate to antibiotics except enterobacteriaceae to imipenem. The pathogens in two groups had higher frequency of multiple antibiotic resistance. Conclusion Gram negative bacilli are the predominant pathogens in refractory pulmonary infection in senile patients and the antibiotic resistance raises markedly. It is important to select antibiotics according to the antibiotics sensitivity in vitro.

关 键 词：难治性肺部感染 病原菌 治疗原则 

分 类 号：R563.1[医药卫生—呼吸系统]