成人原发性肾病综合征并发医院获得性肺炎的病原菌分布及药敏分析  

Investigation of incidence and distribution of pathogenic bacteria and drug sensitivity of the hospital-acquired pneumonia in patients with primary nephrotic syndrome

作　　者：陈美芳[1] 吕冬青[1] 吴小脉[1] 

机构地区：[1]浙江省台州医院呼吸内科,台州317000

出　　处：《临床医学》2007年第12期5-6,共2页Clinical Medicine

摘　　要：目的了解原发性肾病综合征(NS)并发医院获得性肺炎(HAP)的发病率、病原菌分布及对抗生素的敏感性。方法对2004年6月至2006年12月我院收治的43例原发性肾病综合征合并医院获得性肺炎患者进行回顾性分析。结果共分离出细菌51株,其中革兰阴性菌占72.5%,以肺炎克雷伯杆菌、铜绿假单胞菌、不动杆菌、大肠埃希菌最常见;革兰阳性菌占21.6%,主要是金黄色葡萄球菌、表皮葡萄球菌;真菌占3.9%;两种细菌感染的占18.6%,其中真菌均与革兰阴性菌混合感染,占混合感染的25%。致病菌对常用抗生素都不同程度地产生了耐药性,对青霉素、氨苄西林的耐药率最高,对亚胺培南、β-内酰胺酶抑制剂复合剂的耐药率较低,未发现万古霉素耐药革兰阳性球菌。结论革兰阴性杆菌为主要致病菌,其次为革兰阳性菌,多为条件致病菌,且细菌耐药性严重。Objective To investigate incidence, distribution of pathogenic bacteria and drug sensitivity of the hospital - acquired pneumonia in patients with primary nephrotic syndrome （PNS）. Methods We reviewed the data of patients with PNS hospitalized in our hospital from Jun. 2004 to Dec. 2006. Results Among all of the 51 strains, Gram - negative bacteria accounted for 72.5 % , Klebsiella - pneumoniae, Pseudomonas aeruginosa and Escherichia coli were the most common pathagens ; Gram - positive bacteria accounted for 21.6% , mainly staphylococcus aureus, Staphylococcus epidermidis; fungi accounted for 3.9% ; infections with two species of bacteria accounted for 18.6% ;fungi all infected mixed with Gram - negative bacteria, accounted for 25% of mixed infection. Pathogenic bacteria had drug resistance to usual antibiotics in different degree, highly to penicillin and ampicillin,lowly to imipeneme and beta -lactamase suppressive agen, no Gram -positive bacteria had drug resistance to vancomycin. Conclusion Gram - negative bacilli is the mainly pathogen, then is Gram - positive bacteria, which mostly is opportunistic pathogen and have severe drug resistance.

关 键 词：肾病综合征 医院获得性肺炎 病原菌 药物敏感分析 成人 

分 类 号：R692.3[医药卫生—泌尿科学] R446.5[医药卫生—外科学]