新建医院住院患者医院获得性肺炎病原学及耐药性分析  

Etiology and drug resistance of hospital acquired pneumonia suffered by inpatients in new hospital

作　　者：王军[1] 黄娴[1] 李永库[1] 吉泽[1] 王蓓娟[1] 倪殿涛[1] 

机构地区：[1]上海交通大学医学院苏州九龙医院呼吸科,江苏苏州215021

出　　处：《中华医院感染学杂志》2014年第12期2904-2906,共3页Chinese Journal of Nosocomiology

基　　金：上海市卫生厅基金资助项目(SW-2010B-061)

摘　　要：目的探讨新建医院住院患者医院获得性肺炎(HAP)的病原菌分布及耐药性,为临床合理用药提供依据。方法对2010年1-12月入住医院并诊断为HAP的112例患者临床资料进行回顾性分析,所有患者痰标本通过镜检筛选定量培养,并进行菌株鉴定和药敏试验,所有数据采用SPSS16.0软件进行统计分析。结果 112例患者共分离出病原菌178株,其中革兰阴性菌122株占68.54%,革兰阳性菌31株占17.42%,真菌25株占14.04%;鲍氏不动杆对头孢曲松、环丙沙星、头孢他啶的耐药率分别达93.33%、76.67%、70.00%,对其他多数抗菌药物的耐药率均>50.00%,金黄色葡萄球菌对呋喃妥因、米诺环素、磺胺甲噁唑/甲氧苄啶的耐药率较低,分别为5.26%、10.53%、15.79%,对替考拉宁和万古霉素的耐药率为0。结论医院获得性肺炎的病原菌以革兰阴性菌为主,细菌耐药严重,应注重获得病原学依据,并参考药敏试验合理用药。OBJECTIVE To investigate the distribution and drug resistance of pathogens in bodies of HAP patients who were hospitalized in new hospital , so as to provide basis for clinical rational use of drugs . METHODS Retrospectively analyzed the clinical data of 112 HAP patients who were hospitalized during Jan to Dec 2010 ;all patients＇sputum sample were selected through microscopic examination and were cultured quantitatively , then conducted strain identification and susceptibility testing .All data were statistically analyzed through SPSS 16 .0 software .RESULTS A total of 178 strains of pathogens were isolated from the 112 patients ,of which 122 strains of gram-negative bacterium （68 .54% ） ,31 strains of gram-positive bacterium （17 .42% ） and 25 strains of fungi （14 .04% ）;the drug resistance rates of ABA against ceftriaxone ,CPFX and ceftazidime were 93 .33% ,76 .67%and 70 .00% ,while that against other antibacterial agents were all higher than 50 .00% .The drug resistance rates of Staphylococcus aureus against macrodantin ,minocycline and sulfamethoxazole/trimethoprim were 5 .26% , 10 .53% and 15 .79% respectively ,which were lower than others ;while it had no drug resistance to teicoplanin and vancomycin .CONCLUSIONS Gram-negative bacteria are the main pathogens causing HAP .Since it has strong resistance against drugs ,it is necessary to pay more attention to obtain etiology-oriented basis and use drugs rationally by referring antimicrobial susceptibility test .

关 键 词：医院获得性肺炎 病原菌 耐药性 

分 类 号：R563[医药卫生—呼吸系统]