医院获得性肺炎的病原学分布及危险因素分析

Analysis of etiology distribution and risk factors of hospital-acquired pneumonia

目的研究分析医院获得性肺炎的病原学分布及危险因素。方法选取2008年1月-2010年12月,医院的98例医院获得性肺炎患者为研究对象,将其病原学分布特点及高危因素进行统计分析。结果检出病原菌金黄色葡萄球菌占26.19%、肺炎克雷伯菌占19.84%、铜绿假单胞菌占15.87%、鲍氏不动杆菌占11.90%、大肠埃希菌占9.52%,为引起医院获得性肺炎的主要病原菌,而年龄>60岁者的发病率占65.31%,高于≤60岁者的34.69%,ASA分级Ⅲ～Ⅳ级占69.39%,高于Ⅰ～Ⅱ级的30.61%,营养状况差者占71.43%,高于营养状况较好者的28.57%,住院时间>1个月者占66.33%,高于≤1个月者的33.67%,进行侵入性操作者占65.31%,高于未进行侵入性操作者的34.69%,手术治疗患者占66.33%,高于未进行手术治疗者的33.67%,伴有其他基础性疾病者占63.27%,高于未伴有基础性疾病者的36.73%,多种抗菌药物联合应用者占65.31%,高于单用抗菌药物者的34.69%,经比较差异有统计学意义(均P<0.05)。结论医院获得性肺炎的病原学分布及危险因素有其特点,可为其治疗及预防提供依据。

OBJECTIVE To study and analyze the the etiology distribution and risk factors of hospital acquired pneumonia.METHODS A total of 98 patients with hospital acquired pneumonia in our hospital from Jan 2008 to Dec 2010 were selected as research object,and the distribution features of etiology and risk factors of all patients were analyzed.RESULTS Staphylococcus aureus（26.19%）,Klebsiella pneumonia（19.84%）,Pseudomonas aeruginosa（15.87%）,Acinetobacter baumannii（11.90%） and Escherichia coli（9.52%） were the main pathogens caused hospital acquired pneumonia.The incidence of the patients who was more than 60 years old（65.31%） was higher than that of less than 60 years old（34.69%）,the incidence of ASA grade Ⅲ～Ⅳ（69.39%）was higher than that of ASA grade Ⅰ～Ⅱ（30.61%）,incidence of poor nutritional status（71.43%） was higher than that of betters（28.57%）,incidence of hospitalization time 1 month（66.33%） was higher than that of ≤1 month（33.67%）,incidence of patients who were treated with invasive manipulation（65.31%） was higher than that without invasive manipulation（34.69%）,incidence of patients who were treated with surgery（66.33%）was higher than that without surgery（33.67%）,incidence of patients who were with underlying diseases（63.27%） was higher than that without underlying diseases（36.73%）,incidence of patients who were treated with many antibiotics（65.31%） was higher than that treated with single antibiotic（34.69%）,all（P〈0.05）,there were all significant differences.CONCLUSION The etiology distribution and risk factors of hospital acquired pneumonia have their own characteristics,which can provide evidence for the treatment and prevention.