医院内MRSA肺炎多重病原体感染及其药敏分析

The nosocomial MRSA pneumonia with Multi-pathogen infections and their drug susceptiblity

探讨医院内 MRSA肺炎严重混合感染的病原体分布及其对常用抗生素药物敏感性。选择本实验室近 4年来确诊医院内 MRSA肺炎病人痰标本分离的致病菌 ,采用 K- B纸片及 E- test方法分别检测混合感染细菌和真菌对常用抗生素的体外敏感性。结果 6 4例次院内混合感染病原体中细菌 46例次占 71.88% ,真菌 18例占 2 8.13%。细菌对 13种常见抗生素呈现不同程度的严重耐药。其中除曲霉耐氟康唑外 ,部分白念珠菌也出现耐药 ,伊曲康唑和两性霉素 B效果较好。提示医院内 MRSA肺炎常合并多重高度耐药菌感染 ,治疗困难 ,必须进行严格的细菌学分析和耐药监测 ,及时选用有效抗生素。

Objective: To investigate the distribution and the susceptibility of complex pathogens complicated by nosocomial MRSA pneumonia. Methods: The complex pathogens isolated from sputum diagnosed as nosocomial MRSA pneumonia were surveyed and their resistance in vitro against curently used antibiotics were tested by K B and E test. Results: Of 64 complex pathogens, bacterial and fungal infections accounted for 71.88% and 28.13%, respectively. Bacteria appeared diversely high resistance to 13 antibiotics. In addition to aspergillus, the minority of Candida albicans developed resistance to fluconazole; amphotericin B and itraconazole having broadly antifungal activities. Conclusion: Nosocomial pneumonia caused by MRSA often complicate complex infections difficult to treat due to highly resistant pathogens. Strict surveillance of bacteria and fungi must be carried out for rational use of antimicrobial agents.