医院获得性肺炎危险因素及细菌耐药性调查

The Investigation of Risk Factors and Bacterial Resistance to Drugs in Patients with Hospital Acquired Pneumonia

目的探讨医院获得性肺炎感染危险因素、病原菌的分布特点及对抗生素的耐药性。方法对临床确认的140例医院获得性肺炎患者下呼吸道标本进行细菌鉴定和药敏试验,对其临床资料、试验结果进行回顾性分析。结果140例医院获得性肺炎患者中,年龄>60岁者占85%;患各种严重基础疾病者占100%;分离出的184株致病菌中革兰阴性杆菌占60.22%,其中非发酵革兰阴性杆菌占45.53%,且非发酵革兰阴性杆菌对常用抗生素的耐药率高;病原菌在不同的基础疾病中分布有差异。结论革兰阴性杆菌是医院获得性肺炎的主要致病菌群,其耐药率高,加之混合菌株感染增多,难治性强。合理应用抗生素,控制高危因素是降低其感染率的重要因素。

Objective To search into risk factors and characteristics of bacterial distribution and resistance for hospital acquired pneumonia （HAP）. Methods Ideutification of bacteria specimen and drug sensitivity test were performed in specimens from the lower respiratory tract of 140 patients with HAP.The test resuhs and clinical data were analysed. Results 85% among 140 patients were more than 60 years old; 100% had a severe underlying diseases, Gram negative bacilli accounted for 60.87% among 184 strains of bacteria in which 45.53% were non-fermentation Gram negative bacilli. Drug sensitivity test results showed that resistance to various antibiotics was highest in non fermeutatiou gram negative. Pathogens were different in various basic diseases. Conclusion Gram negative bacilli are the major pathogens, which have high resistance rate and with multi pathogen increasing. They are difficult to control. To decrease the infection rate, it is necessary to use antibiotic reasonably and control high risk factors.