深圳市罗湖区126例社区获得性肺炎病原体分布

Etiological distribution of 126 cases of community acquired pneumonia in Luohu District of Shenzhen City

目的探讨社区获得性肺炎病原学分布及病原菌的耐药性,为制定防治策略和措施提供科学依据。方法收集深圳市罗湖区人民医院2010年1月—2012年12月社区获得性肺炎患者126例,留取痰液进行细菌培养,应用常规方法分离鉴定细菌,并分析病原菌的耐药性,同时检测患者肺炎支原体、肺炎衣原体血清抗体。结果共有53例患者病原学阳性,病原体分布情况为:肺炎支原体(23例)、流感嗜血杆菌(15例)、肺炎克雷伯菌(6例)、肺炎链球菌(5例)、肺炎衣原体(3例)。肺炎链球菌对青霉素、三代头孢、大环内酯类抗生素敏感,对喹诺酮类、磺胺抗生素耐药;流感嗜血杆菌仅对三代头孢高度敏感,对青霉素、喹诺酮类、磺胺类、大环内酯类耐药。高年龄组和春季病原菌阳性率较高,单个病原体在不同季节间分布差异无统计学意义,在不同年龄组间分布差异无统计学意义。结论非典型病原体尤其是肺炎支原体感染在罗湖社区获得性肺炎中占据主要地位,流感嗜血杆菌是社区获得性肺炎主要致病菌。不同季节、不同年龄病原体分布无明显差异。

[ Objective] To investigate the etiological distribution and bacterial resistance of community acquired pneumonia （CAP） , and provide scientific basis for developing its prevention and control strategies. [Methods] A total of 126 cases of CAP were collected from January 2010 to December 2012 at the Peoples Hospital of Luohu District. Sputum samples were collected for bacteria culture. Bacteria were isolated and identified by conventional methods. Bacterial resistance was also analyzed. Antibodies of serum samples to mycoplasma pneumonia, chlamydia pneumonia were detected. [Results] The pathogens was identified in 53 patients. The distribution of pathogens was as followed： mycoplasma pneumonia （23 cases） , haemophilus influenzae （ 15 cases） , klebsiella pneumoniae （6 cases） , streptococcus pneumoniae （5 cases） and chlamydia pneumoniae （3 cases）. The streptococcus pneumoniae was sensitive to penicillin, the third generation cephalosporin and macrolides, resistant to quinolones and sulfonamides. Haemophilus influenzae was highly sensitive to the third generation cephalosporin, but resistant to penicillin, macrolides, quinolones and sulfonamides. Positive incidence of pathogenic bacteria was higher in spring and old age group, but the distribution of every single pathogen had no significant difference beween different age groups and seasons. [Conclusion] Atypical pathogens especially mycoplasma pneumonia plays important roles in CAP infection. Haemophilus influenzae is the most common bacteria for CAP. The distribution of pathogens has no significant difference between different age groups and seasons.