76例医院获得性肺炎临床特点分析  

Analysis of Clinical Features in 76 Patients with Hospital-acquired Pneumonia

作　　者：符岳[1] 姜骏[1] 梁炼[2] 袁莺[1] 许婉华[1] 曾慧祺[1] 颜梅[1] 黄子通[2] 

机构地区：[1]广东省佛山市第一人民医院急诊科,528000 [2]中山大学孙逸仙纪念医院急诊科

出　　处：《岭南急诊医学杂志》2013年第4期252-254,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨医院获得性肺炎(HAP)的临床特点、病原学分布和药敏情况,以指导临床诊疗。方法:回顾性分析2008年1月-2012年12月收治的76例HAP患者的临床资料。结果:HAP的发生率为1.69%,所有患者均有相关基础疾病和易患高危因素,合并两种以上基础疾病者死亡率高。分离的病原菌中,革兰氏阴性菌占60.17%,革兰氏阳性菌占32.20%,真菌占6.78%,不动杆菌、铜绿假单胞菌、肺炎克雷白杆菌、金黄色葡萄球菌为主要致病菌。不动杆菌、产ESBLs的肺炎克雷白杆菌耐药率较高,但碳青霉烯类和β-内酰胺类抗生素/酶抑制剂治疗效果仍较好,所有革兰氏阳性菌对万古霉素和利奈唑胺敏感。结论:减少各种高危因素,严格进行病原学检测和药敏试验,针对病原菌情况合理应用抗生素是提高HAP疗效的关键。Objective： To study the clinical characteristics, distribution and drug susceptibility of hospital- acquired pneumonia （HAP） to guide chnical diagnosis and treatment. Methods： The chnical data of 76 patients with HAP were analyzed retrospectively from Jan 2008 to Dec 2012. Results： The incidence rate of HAP was 1.69%. Relevant underlying diseases and high risk factors had been found in all the cases. The patients with two underlying diseases had a higher mortality rate. Of all isolated pathogens,gram-negative bacilli,gram-positive bacilli,fungal accounted for 60.17%, 32.20%, 6.78%, respectively. The most common pathogens of HAP were Acinetobacter, Pseudomonas aeruginosa, Klebsiella pneumoniae and staphylococcus aureus. Acinetobacter and ESBL-producing klebsiella pneumonia had higher drug resistant rates, however, were still sensitive to Carbapenem and β-lactam anticiotics/inhibiter of β-lactamases. Gram-positive bacteria were all susceptible to vancomycin and linezolid. Conclusions： Reducing the risk factors and performing pathogenic examination and drug sensitive test strictly is the key to improve the curative effect for HAP.

关 键 词：医院获得性肺炎 危险因素 病原学 药敏 

分 类 号：R563.1[医药卫生—呼吸系统]