500例肺炎病原菌构成分析

Analysis on the composition of pneumonic pathogenic bacteria in 500 cases

目的调查500例肺炎病原菌构成特点,为临床治疗提供参考依据。方法回顾性分析2004年1月-2006年10月,500例肺炎患者痰标本细菌培养结果。结果500例患者共分离出细菌334株,其中社区获得性肺炎患者分离菌株73株;医院获得性肺炎患者分离菌株265株。老年肺炎患者(>60岁)共分离出细菌258株,其中社区获得性肺炎分离菌株56株;医院获得性肺炎患者分离菌株202株,有23例患者出现≥二重病原菌感染。结论嗜血杆菌是社区获得性肺炎主要致病菌之一。医院获得性肺炎排首位的是铜绿假单胞菌,葡萄球菌属呈上升趋势;老年社区获得性肺炎革兰阴性杆菌的检出率明显增加。假单胞菌属、葡萄球菌属、肺炎克雷伯氏菌、不动杆菌等,已成为老年患者医院获得性肺炎的常见病原菌。高龄、严重的基础疾病、抗菌素的反复使用是引起下呼吸道双重感染的危险因素。

Objective To investigate the characteristics of the composition of 500 pneumonic pathogen and provide references for clinical treatment. Methods The cultured bacteria of sputum from 500 pneumonic patients who were admitted to hospital from January 2004 to October 2006 were retrospectively analyzed. Results Isolated from 500 pneumonic patients were 334 strains of bacteria, of which 73 strains were isolated from patients with the community acquired pneumonia （CAP） and 265 strains were isolated from pateints with hospital acquired pneumonia （HAP）. Of 258 strains isolated from senile patients （more than 60 years）, 56 strains were isolated from patients with CAP, and 202 isolated strains were from patients with HAP. There were 23 patients with superinfection. Conclusion Hemophilus is the major pathogen. The most common pathogen of HAP is pseudomonas aeruginosa. The infection rate of Staphylococcus is going up. The detection rate of Gram-Negative Bacilli from patients with CAP has obviously increased. The common pathogens are Pseudomonas, Staphylococcus, Klebsiella pneumoniae and Acinetobacter in old CAP patients. The dangerous factors in patients with superinfection in lower respiratory tract are caused by old age （more than 60 years）, severe underlying diseases and repetitive use of antibiotic.