院内获得性肺炎60例临床分析

Clinical Analysis of 60 Patients with Hospital Acquired Pneumonia

目的:了解院内获得性肺炎的临床特点及病原菌分布,改善预后。方法:回顾性分析2004年1月-2009年12月收治的院内获得性肺炎60例的临床资料。结果:基础病是血液病18例(30%),脑血管病9例(15%):临床症状中发热占96.7%,咳嗽占63.3%;痰培养阳性率95.0%,铜绿假单胞菌和肺炎克雷伯氏菌为两个主要致病菌,药敏试验发现铜绿假单胞菌对第三代头孢菌素耐药性增加,肺炎克雷伯氏菌对多种抗生素产生耐药。铜绿假单胞菌感染病人死亡率为58.1%,肺炎克雷伯氏菌感染为48.4%,混合感染为67.7%。结论:院内获得性肺炎的病人基础病多,病原菌对抗生素耐药率高,治疗难度大,预后差。

Objective： To understand the clinical characters of hospital acquired pneumonia （HAP）and distributions of nosophyte and to improve the prognosis. Methods： The clinical data of 60 patients with HAP from Jan 2004 to Dec 2009 were retrospectively analyzed.Result： Among the primary diseases, hematologic disorder （18 cases, 30%） ranked the first, followed by cerebrovascular diseases （9 cases, 15%）. Fever occurred in 96.7% of the patients arid cough 63.3%. The positive rate of sputum bacterial culture was 95.0%. Two major pathogens were Pseudomonas aeruginosa and Klebsiella pneumonia. P.aeruginosa showed more resistance to the third generation of cefalosporins than before, the death rate to infection of Pseudomonas aeruginosa was 58.1%, to Klebsiella pneumonia was 48.4%, and mixed infection was 66.7%. Conclusion： The clinical manifestation of HAP is atypical, and the rate of resistance is high. It is difficult to treat and the death rate is high.