82例肺脓肿致病菌及耐药性分析

Pathogenic species and drug resistance:analysis of 82 cases of lung abscess

目的探讨引起肺脓肿的病原菌的分布及耐药情况,指导临床合理应用抗生素。方法分析我院2004年1月至2008年8月收治的82例肺脓肿的感染致病菌。结果42例伴基础疾病的肺脓肿以革兰阴性杆菌感染为主,无基础疾病的以革兰阳性球菌居多;革兰阴性菌中常见致病菌为肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌和不动杆菌,对常用抗生素的敏感药物有:亚胺培南,哌拉西林-三唑巴坦,头孢哌酮-舒巴坦,阿米卡星,头孢吡肟,环丙沙星。结论在肺脓肿的起始经验性治疗时,伴有基础疾病的应首选抗革兰阴性杆菌的敏感药物,但是头孢吡肟、环丙沙星已严重耐药。

Objective To investigate the pathogenic species and drug resistance in patients with lung abscess and to guide clinical application of antibiotics. Methods A retrospective analysis was made on the 82 cases of infection pathogens with lung abscess from January 2004 to August 2008. Results Gram negative bacteria was the major pathogen in patients of lung abscess with basic diseases. On the contrary, gram positive bacteria was the major pathogen in patients of lung abscess without basic diseases. Among gram negative bacteria, the major sputum was klebsiellapneumoniae, pseudomonas aeruginosa, escherichia coli and acinetobacter. The sensitivity of drug from high to low was as follows： imipenem, pip-eracillin-tazobactam,cefoperazone-sulbactam,amikacin,cefepime and ciprofloxacin. Conclusion Major cause of lung abscess with basic diseases may be gram negative bacteria. However,cefepime and ciprofloxacin have serious resistance.