早发医院获得性肺炎病原菌分布与耐药性分析  

Distribution and drug resistance of pathogens causing early hospital-acquired pneumonia

作　　者：吴春玲[1] 楼翰健[1] 陈国钟[1] 滕一鸣[1] 

机构地区：[1]义乌市中心医院呼吸内科,浙江义乌322000

出　　处：《中华医院感染学杂志》2012年第22期5150-5152,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解早发医院获得性肺炎(HAP)病原菌的分布及耐药性,以指导临床预防与用药。方法入选早发且无多药耐药危险因素的患者118例,采集合格痰标本,进行细菌分离、鉴定和药敏试验。结果入选的118例HAP患者共分离出121株病原菌,其中革兰阳性菌30株,革兰阴性菌86株,真菌5株,分别占24.8%、71.1%、4.1%;革兰阳性菌对青霉素耐药率较高,达93.3%,对左氧氟沙星、莫西沙星及头孢曲松耐药率均较低,分别为20.0%、6.7%和16.7%,革兰阴性菌对哌拉西林耐药率为22.1%,对其余大部分抗菌药物均<20.0%,真菌无耐药。结论在早发HAP中,革兰阴性杆菌仍是主要的病原菌,社区获得性感染病原体在早发HAP中占有一定的比例,对致病起重要作用,而耐药性相对较低,对于经验性抗菌药物的选择有重要的指导作用。OBJECTIVE To investigate the distribution and drug resistance of pathogens causing early hospital-acquired pneumonia（HAP）,so as to guide clinical prevention and treatment.METHODS The collection of the qualified sputum samples,bacterial isolation,identification and drug susceptibility testing were performed for 118 patients with early hospital-acquired pneumonia.RESULTS Of 118 patients with HAP enrolled,totally 121 strains of pathogens were isolated,including 30（24.8%） strains of gram-positive bacteria,86（71.1%）strains of gram-negative bacteria and 5（4.1%）strains of fungi;the drug resistance rate of the gram-positive bacteria reached up to 93.3%,the drug resistance rates to levofloxacin,moxifloxacin and ceftriaxone were 20.0%,6.7%,and 16.7%,respectively,the drug resistance rate of the gram-negative bacteria to piperacillin was 22.1%,the drug resistance rates to most of other antibiotics were less than 20.0%,the fungi were susceptible to antifungal drugs.CONCLUSION Gram-negative bacilli remain the predominant pathogens causing early HAP,community-acquired pneumonia takes a certain proportion in the early HAP and plays an important role in causing diseases,the drug resistance is relatively low,which had great significance in the guidance for the selection of empirical antibacterial drugs.

关 键 词：医院获得性肺炎 病原菌 构成 耐药性 

分 类 号：R378[医药卫生—病原生物学]