冬季社区获得性肺炎的病原菌及耐药性分析

The composition and drug resistance of pathogenic bacteria of community-acquired pneumonia in winter

目的：了解2013年冬季该院社区获得性肺炎（ community acquired pneumonia ，CAP）住院患者中致病菌的构成比、常见致病菌的耐药情况，为CAP的诊断及经验治疗提供依据。方法回顾性分析2013－10-2014－03该院收治所有确诊为CAP患者108例的临床资料及病原学检查资料。结果108例患者送检痰标本128例，检出致病菌64株，检出率为50．0％，肺炎克雷伯杆菌、白色念珠菌为前两位菌种。肺炎克雷伯杆菌对碳青霉烯类、第三代头孢菌素、喹诺酮类药物敏感性较高，对第一代、二代头孢菌素及大环内酯类药物耐药性较高。结论冬季获得性肺炎致病菌以革兰阴性菌为主，最常见为肺炎克雷伯杆菌。对于老年患者，合并慢性阻塞性肺疾病、支气管扩张等基础病的患者应重视抗革兰阴性菌治疗。

Objective To investigate the composition of pathogenic bacteria and drug resistance of common pathogenic bacteria in hospitalized patients with community acquired pneumonia （ CAP） in the winter of 2013 in our hospital,and provide the basis for the diagnosis and empirical therapy of CAP .Methods The clinical data and etio-logical data of 108 CAP patients were analyzed in the hospital from Oct .2013 to Mar.2014 by retrospective research methods.Results In 128 sputum specimens from 108 CAP patients, 64 strains pathogenic bacteria were detected , the detection rate was 50.0%,with klebsiella pneumoniae and candida albicans as the first two strains .The sensitivity of klebsiella to carbapenems , the third generation cephalosporins and quinolones was higher .The drug resistance of klebsiella pneumoniae to the first generation and second generation cephalosporins and macrolides was higher .Con-clusion Pathogens of acquired pneumonia in winter mainly is gram-negative bacteria , and the most common is kleb-siella pneumoniae .For the eldly patients suffered from basic diseases such as chronic obstructive pulmonary disease or bronchiectasis disease and so on , the therapy of anti-gram-negative bacteria should be paid attention to .