医院获得性肺炎病原菌及耐药分析

Distribution of Bacteria and Analysis of Drug Susceptibility in Hospital Acquired Pneumonia Patients

目的了解医院获得性肺炎(HAP)病原菌的分布特点及耐药性,有利于早期经验性使用抗菌药物。方法对医院2007年1-12月确诊为医院获得性肺炎的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。结果共确诊HAP患者136例,老年患者所占比例远高于其他年龄患者,年龄>60岁的占75.00%,病原菌主要为革兰阴性杆菌,占57.62%;革兰阳性菌对红霉素(89.13%)、青霉素(91.30%)高度耐药,对万古霉素、美罗培南均敏感;革兰阴性菌对美罗培南敏感度较高,对三代头孢菌素及喹诺酮类抗菌药物耐药率>50.00%,加入β-内酰胺酶抑制剂后耐药率明显下降。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,混合菌株感染多,难治性强,合理应用抗菌药物、控制高危因素是降低其感染率的重要因素。

OBJECTIVE To study the features of isolated bacteria from sputum specimens in the patients with hospital acquired pneumonia （HAP）. METHODS Identification of bacteria specimen and drug sensitivity test were performed in specimens from the lower respiratory tract of patients with HAP from Jan 2007 to Dec 2007. The test results and clinical data were analyzed. RESULTS There were 136 patients with HAP, among them the old persons who were more than 60 years old and 75% of them were infected much more than others. The main pathogens were Gram-negative bacilli （57.62%）. CONCLUSIONS Gram-negative bacilli are the major pathogens with high resistance rate and the multi pathogen infection is increasing and difficult to control. To decrease the infection rate, it is necessary to use antibiotic reasonably and control high risk factors.