重症社区获得性肺炎的病原体分布及药物敏感性分析  

Analysis of the distribution and drug sensitivity of pathogen in severe community acquired pneumonia

作　　者：范家珊[1] 李有霞[1] 陆莎[1] 顾艳[1] 

机构地区：[1]遵义医学院第五附属(珠海)医院呼吸内科,519100

出　　处：《实用医学杂志》2011年第11期2047-2049,共3页The Journal of Practical Medicine

摘　　要：目的:分析重症社区获得性肺炎的病原体分布及其敏感药物,从而指导合理应用抗生素。方法:选取我院住院的重症社区获得性肺炎患者103例,对其进行痰液病原体检测和药敏试验,并统计分析检验结果。结果:分离出113株病原体,革兰阴性杆菌是最常见的病原菌(占53.9%),其中前四位为肺炎克雷伯杆菌、铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌等;这些细菌对大部分抗生素尤其是三代头孢类抗生素耐药严重,但对哌拉西林、亚胺培南-西司他丁钠、环丙沙星、丁胺卡那霉素仍保持较高的敏感性。革兰阳性菌占46.1%;合并真菌感染15.9%。结论:本地区重症社区获得性肺炎的致病菌以革兰阴性杆菌为主,合并真菌感染的几率较高。临床中应严密监测本地区病原体的构成,参照药敏结果合理应用抗生素,从而提高临床疗效及抑制耐药菌产生。Objective To analysis the distribution and sensitive drug of pathogenic bacteria in severe community acquired pneumonia, then guide to use antibiotic reasonably in practice. Methods 103 cases of severe community acquired pneumonia were selected in our hospital, and took their sputum to classified the pathogenic bacteria, and had drug sensitive test. Results 113 pathogenic bacteria have been found,. Gram-negative bacteria were the most common （53.8%）, and the top four pathogens are K. peumoniae, p.aeruginosa, A. baumannii and E.coli. These bacterias were resistant to many of antibiotics, particularly for the third-generation cephalosporin, but sensitive to piperacillin, imipene, ciprofloxacin and amikacin. Gram-positive bacteria accounted for 46.1% ; mixed fungu infections were 15.9%. Conclusions Gram-negative bacteria are the most common pathogens for the severe community acquired pneumonia in our community, the incidence of mixed infection with fungu is high. The constituent of pathogens should be monitored in clinical practise, antibiotics should be selected reasonably according to the drug sensitivity, so as to improve the clinical effect and inhibit the production of resistant bacterias.

关 键 词：肺炎 社区获得性 病原体 抗生素 

分 类 号：R563.1[医药卫生—呼吸系统]