2010年1月-2013年1月我院难治性肺炎患者的病原菌及其耐药性分析

Analysis of Pathogenic Bacteria of Refractory Pneumonia and Its Drug Resistance in Our Hospital during Jan. 2010-Jan. 2013

目的:了解我院难治性肺炎的病原菌及其耐药性,为临床用药提供指导。方法:采用回顾性分析方法,对2010年1月-2013年1月我院干部科、呼吸科、脑外科等难治性肺炎患者的痰、血标本进行培养,采用纸片法进行药敏试验。结果与结论:125例患者中,87例痰培养标本分离出病原菌,其中革兰阳性(G+)菌36例(41.38%),革兰阴性(G-)菌50例(57.47%),真菌1例(1.15%);68例血培养标本分离出病原菌,其中G+菌33例(48.53%),G-菌35例(51.47%)。G+菌除对万古霉素、替考拉宁敏感外,对其他的抗菌药物几乎耐药。难治性肺炎的病原菌以G-菌居多,且非发酵糖菌中铜绿假单胞菌和鲍曼不动杆菌所占的比例较高,呈多重耐药和泛耐药。

OBJECTIVE： To know the pathogenic bacteria of refractory pneumonia and its drug resistance, and to provide refer-ence for clinical medication. METHODS： By retrospective analysis, sputum samples and blood samples of cadre department, de-partment of respiration, and department of cerebral surgery of our hospital were cultured during Jan. 2010--Jan. 2013. The suscepti- bility test was performed by disk diffusion method. RESULTS ＆ CONCLUSIONS： Pathogenic bacteria were isolated from 87 spu- tum samples of 125 patients： 36 cases were Gram-positive bacteria （41.38%）, 50 cases were Gram-negative bacteria （57.47%） and 1 case was fungus （1.15%）; pathogenic bacteria were isolated from 68 blood samples： 33 cases were Gram-positive bacteria （48.53%）, and 35 cases were Gram-negative bacteria （51.47%）. The susceptibility test showed that Gram-positive bacteria were sensitive to vancomycin and teicoplanin, and almost resistance to other antibacterial. Major pathogenic bacteria of refractory pneu-monia are Gram-negative bacteria. Pseudomonas aeruginosa and Acinetobacter baumannii occupy the highest proportion among staphylococcus asaccharolyticus, showing multi-drug resistance or pan-drug resistance.