76例医院获得性肺炎患者病原学分布及耐药性分析

Distribution and drug resistance of pathogens in 76 patients with hospital acquired pneumonia

目的:探讨医院获得性肺炎(HAP)患者的病原学分布及耐药性。方法:采集76例HAP患者的呼吸道分泌物标本进行检测。结果:76例HAP患者病原学检测阳性,其中7例为混合感染,分离鉴定出病原菌85株,以革兰氏阴性菌为主,其次为革兰氏阳性菌;革兰氏阴性菌中主要致病菌为铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌,对氨苄西林钠、庆大霉素等的耐药率均在50.00%以上。革兰氏阳性菌中主要为金黄色葡萄球菌、凝固酶阴性葡萄球菌,对常用抗菌药物耐药性均较高,两者均未发现万古霉素耐药株。结论:HAP致病病原菌以革兰氏阴性菌为主,细菌耐药严重,而且出现耐多药菌株,应根据药敏结果慎重合理选用抗生素,同时采取措施控制耐药菌传播,降低医院感染率。

Objective: To investigate distribution and drug resistance of pathogens in 76 patients with hospital acquired pneumonia( HAP). Methods: The respiratory tract secretion specimens from 76 patients with HAP were collected and detected by the CDC. Results: The 76 cases of HAP were positive in the pathogenic detection,7 of them were mixed infection,and 85 strains could be isolated and identified. The gram negative bacteria were the main pathogenic bacteria,followed by gram positive bacteria. The main pathogenic bacteria in the gram negative bacteria were Pseudomonas aeruginosa bacteria,pneumonia Klebsiella,Acinetobacter baumannii,whose ampicillin and gentamicin resistance rate were above 50. 00%. The main pathogenic bacteria in the gram positive bacteria were Staphylococcus aureus and coagulase negative staphylococci,whose antimicrobial drug resistance was higher. No vancomycin resistant strains were found in the two groups. Conclusions: HAP pathogenic bacteria is mainly the gram negative bacteria with serious bacterial resistance and multidrug resistant strains,therefore,it should rational use antibiotics according to the drug sensitivity results,and should take measures to control the spread of resistant bacteria and reduce the hospital infection rate.