重症颅脑损伤合并医院获得性肺炎病原菌及用药分析  

Analysis of antimicrobial susceptibilities of pathogens and antimicrobial drug use in patients with severe craniocerebral injury and hospital-acquired pneumonia

作　　者：沈发英 尹寿祥[2] SHEN Faying;YIN Shouxiang(Department of Pharmacy,the Second Affilited Hospital of Wannan Medical College,Wuhu 241000,China;Department of Pharmacy,Maanshan Municipal People′s Hospital,Maanshan 243000,China)

机构地区：[1]皖南医学院第二附属医院药剂科,芜湖241000 [2]马鞍山市人民医院药事科,马鞍山243000

出　　处：《西北药学杂志》2019年第2期261-266,共6页Northwest Pharmaceutical Journal

摘　　要：目的研究重症颅脑损伤患者合并医院获得性肺炎(HAP)病原菌药物敏感性及分析抗菌药物的使用情况,为临床合理用药提供依据。方法对近5年179例重症颅脑损伤合并HAP患者的资料进行回顾性分析。结果在179例重症颅脑损伤合并HAP患者中,早发49例,晚发130例,二者在性别、年龄和重症HAP患者比例上差异均无统计学意义(P>0.05)。病原菌以革兰阴性菌为主,共203株(57.83%),其中鲍曼不动杆菌71株(20.23%),肺炎克雷伯杆菌50株(14.25%),铜绿假单胞菌35株(9.97%)。革兰阳性菌97株(27.64%),以金黄色葡萄球菌为主38株(10.83%)。抗菌药物使用率为100%,以β-内酰胺类复方制剂和喹诺酮类为主,其中联合用药为79.33%,给药途径以静脉滴注为主。结论重症颅脑损伤合并HAP患者主要病原菌为革兰阴性菌;抗菌药物使用基本合理,部分治疗方案仍需进一步优化。Objective To investigate the susceptibility results of pathogens and antimicrobial drug use in patients with severe craniocerebral injury and hospital-acquired pneumonia (HAP) so as to provide basis for clinical rational drug use.Methods The clinical data collected from 179 patients with severe craniocerebral injury and HAP in the past 5 years were retrospectively analyzed.Results The 179 patients with severe craniocerebral injury and HAP included 49 cases of early onset and 130 cases of late onset.And there was no significant difference in sex,age,and the proportion of severe HAP patients ( P >0.05).There were 203 (57.83%) strains of Gram-negative bacteria which were the main pathogens causing HAP,among which there were 71 (20.23%) strains of Acinetobacter baumannii ,50(14.25%) strains of Klebsiella pneumoniae ,and 35(9.97%) strains of Pseudomonas aeruginosa .There were 97(27.64%) strains of Gram-positive bacteria,the majority of which was Staphylococcus aureus (38 strains,10.83%).The utilization rate of antibacterial drugs was 100%,mainly composed of β-lactam compound preparations and quinolones.79.33% of the cases used antibacterial drugs combined and the most way was intravenous administration.Conclusion The main pathogens in patients with severe craniocerebral injury and HAP were Gram-negative bacteria.The application of antibacterial drugs were basically rational.Some treatment perscriptions still need to be improved.

关 键 词：抗菌药物 病原菌 重症颅脑损伤 医院获得性肺炎 合理用药 

分 类 号：R969.3[医药卫生—药理学]