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作 者:廖晚珍[1] 彭卫华[1] 胡雪飞[1] 孙爱娣[2] 余阳[1] 温桂兰[3] 陈国华[3]
机构地区:[1]南昌大学第一附属医院检验科呼吸科,江西南昌330006 [2]南南昌大学第一附属医院检验科呼吸科,江西南昌330006 [3]南昌大学第一附属医院,江西南昌330006
出 处:《实验与检验医学》2009年第6期595-598,共4页Experimental and Laboratory Medicine
基 金:江西省卫生厅基金资助(合同编号:041052)
摘 要:目的掌握我省引起社区获得性肺炎(CAP)的病原谱和细菌药敏谱,为CAP的抗菌治疗提供依据。方法细菌的分离与鉴定采用常规法和仪器法,最小抑菌浓度(MIC)的检测采用琼脂稀释法,非典型病原体中的肺炎支原体采用微量颗粒凝集(MAG)法,肺炎衣原体采用微量免疫荧光(MIF)法,军团菌采用间接荧光免疫(IFA)法和酶免疫测定(EIA)法检测。结果肺炎支原体和肺炎链球菌明显占第一、第二位,然后是嗜血杆菌和肺炎克雷伯菌。细菌的MIC是随着病原体和药物的不同而不同。结论细菌引起的CAP可先行经验治疗,待病原学和药敏报告后视情况进行调整;非典型病原体引起的CAP主要靠经验治疗,但药物的选择应安全、有效并能覆盖所有非典型病原体和常见菌。Objective To understand the pathogen spectrum and antimicrobial susceptibility spectrum of community-acquired pneumonia (CAP) for the antibiotic therapy. Methods Isolation and identification of bacteria were detected by common practice and instrumental method respectively. The minimal inhibitory concentration (MIC) was detected by agar dilution method, and with Mycoplasma pneumonia by microagglutination test (MAG), Chlamydia pneumoniae by microimmunofluorescence(MIF), Legionella by indirect immunofluorescence assay(IFA) and enzyme immunoassay(EIA). Results The common pathogens of CAP showed Mycoplasma pneumonia and Streptococcus pneumoniae were accounted for the first and the second apparently, following by Haemophilus and Klebsiella pneumoniae. The MICs of bacteria were varied with different pathogens and medicines. Conclusions Experiencial treatment may be used to CAP caused by bacteria and be adjusted according to the etiology and antimicrobial susceptibility reports. The treatment of CAP caused by atypical pathogens depends mainly on experience. However, the selected drugs should be safety, effective, and related to all atypical pathogens and common bacteria.
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