慢性肾衰竭合并肺部感染176例临床分析  

Clinical analysis of hospitalized patients with chronic renal failure complicated by pulmonary infection

作　　者：商进春[1] 

机构地区：[1]青岛大学医学院附属医院肾内科,山东青岛266000

出　　处：《西部医学》2011年第9期1707-1709,共3页Medical Journal of West China

摘　　要：目的了解慢性肾衰竭合并肺部感染患者的致病菌分布及药敏情况,比较社区获得性肺炎(CAP)和医院获得性肺炎(HAP)的病原谱差异和耐药强弱。方法分析176例慢性肾衰竭合并肺部感染患者的痰培养和药敏测定结果。结果 176例痰培养致病菌分布为:革兰阴性杆菌62株(48.4%),真菌42株(32.8%),革兰阳性球菌24株(18.8%),革兰阳性球菌主要包括葡萄球菌,革兰阴性杆菌主要包括肺炎克雷伯杆菌、鲍曼不动杆菌和铜绿假单胞菌。CAP和HAP组均以革兰阴性杆菌和真菌为主,两组对多种抗生素耐药性较高,HAP组明显高于CAP组。结论慢性肾衰竭患者合并CAP与HAP病原菌均以革兰阴性杆菌和真菌多见,两组病原谱差异和耐药情况存在统计学差异。临床应重视慢性肾衰竭合并肺部感染患者痰培养及抗生素的合理使用。Objective To determine the causative organism and antimicrobial susceptibility of community and hospital acquired pneumonia（CAP and HAP） in chronic renal failure complicated by pulmonary infection in hospital.Methods The data of bacteria and spectrum and their drug susceptibility in patients with chronic renal failure complicated by pulmonary infection were retrospectively analyzed.Results The isolated bacteria of spectrum cultural of 176 cases included 62 gram negative bacilli（48.4%）,42 fungus（32.8%） and 24 gram-positive cocci（18.8%）,G＋ cocci mainly included staphylococci,G-bacilli mainly included Klebiella pneumoniae,Bowman immovability bacillus and Pseudomonas aeruginosa.In both CAP and HAP,fungus and G-bacilli were the dominant pathogens.The pathogenic bacteria were resistant to multi-antibiotics,and the resistant rates from HAP patients was higher than those from CAP.ConclusionFungus and G-bacilli were the dominant pathogens.Phlegm culture and drug sensitive test are helpful for reasonable use of antibiotics for patients with chronic renal failure complicated by pulmonary infection in clinical practice.

关 键 词：慢性肾衰竭 肺部感染 痰培养 药物敏感性试验 

分 类 号：R692.5[医药卫生—泌尿科学]