医院获得性肺炎病原菌细菌耐药性分析  

Drug resistance pattern of bacteria from patients with hospital-acquired pneumonia

作　　者：汪瑞忠[1] 方琴[2] 房华[1] 杜丽华[1] 毛美丽[1] 奚峰[3] 孙孝峰[4] 瞿静华[4] 丁爱民[4] 

机构地区：[1]上海市浦东新区人民医院检验科,上海201200 [2]上海市浦东新区人民医院高压氧科,上海201200 [3]上海市浦东新区人民医院呼吸内科,上海201200 [4]上海市浦东新区人民医院院内感染办公室,上海201200

出　　处：《中国感染与化疗杂志》2011年第1期54-56,共3页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解上海市浦东新区人民医院住院患者医院获得性肺炎(HAP)病原菌耐药情况的现状,为经验用药提供依据。方法收集2008—2009年HAP患者100例的分离菌进行细菌耐药性分析。结果金葡菌占第1位,耐甲氧西林金葡菌(MRSA)检出率为52.4%;耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率为87.5%;除万古霉素、替考拉宁、利奈唑胺、利福平外,MRSA、MRCNS与甲氧西林敏感金葡菌(MSSA)之间的耐药率有很大的差别。产超广谱β内酰胺酶(ESBLs)肺炎克雷伯菌检出率为42.9%;产ESBLs和非产ESBLs的肺炎克雷伯菌之间的耐药率有很大的差别。嗜麦芽窄食单胞菌排列第2位。结论 HAP患者中MRSA的检出率高于该院2005年的检出率;MRCNS的检出率与该院2005年检出率相近;产ESBLs肺炎克雷伯菌的检出率比该院2005年的检出率稍高。HAP患者中MRSA、MRCNS、产ESBLs肺炎克雷伯菌的细菌耐药率比2008年本市平均水平低,建议各地区建立自己的细菌耐药情况数据库。Objective To understand the antibiotic resistance pattern of the bacterial pathogens isolated from patients with hospital-acquired pneumonia （HAP） in People＇s Hospital of Pudoug District. Methods The bacterial pathogens （n = 100） isolated from HAP patients were tested for susceptibility to antibiotics. Results S. aureus was the most frequently isolated pathogen from HAP patients. The prevalence of MRSA was 52.4%. About 87. 5% of the coagulase negative Staphylococcus isolates were resistant to methicillin （MRCNS）. With the exception of vancomycin, teicoplanin, linezolid, rifampin, methicillin-resistant Staphylococcus showed the antibiotic resistance pattern very different from the methicillin-susceptible Staphylococcus. ES- BLs were produced in 42. 9% of the K. pneumoniae isolates. ESBI.s positive and ESBLs-negative K. pneurnoniae strains showed very different resistance pattern. Conclusions The antibiotic resistance pattern has been changing over years. It is important to update the local databases of antimicrobial susceptibility testing in time to support clinical therapy.

关 键 词：医院获得性肺炎 呼吸机相关肺炎 细菌耐药性 甲氧西林耐药金葡菌 甲氧西林耐药凝固酶阴性葡萄球菌 超广谱Β内酰胺酶 

分 类 号：R446.5[医药卫生—诊断学]