隐匿性肺炎的病原菌分布情况及耐药性分析

Analysis of pathogen distribution and drug resistance in occult pneumonia

目的分析隐匿性肺炎的病原菌分布情况及耐药性,以期为临床抗菌药物的合理使用提供参考依据。方法选取2017年5月至2020年5月我院收治的118例隐匿性肺炎患者作为研究对象,采集痰液分析病原菌分布情况,同时进行药敏试验。结果从118例隐匿性肺炎患者中总共分离出病原菌168株,其中革兰阴性菌84株,占50.00%,以鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌为主,分别占42.86%、25.00%、19.05%、5.95%;革兰阳性菌58株,占34.52%,以金黄色葡萄球菌、肺炎链球菌、停乳链球菌似马亚种为主,分别占58.62%、31.03%、6.90%;真菌26株,占15.48%,以白色假丝酵母菌为主,占80.77%。鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌对亚胺培南的耐药性较低。金黄色葡萄球菌、肺炎链球菌、停乳链球菌似马亚种对万古霉素的耐药性为0.00%。结论隐匿性肺炎患者的病原菌以革兰阴性菌为主,同样存在部分革兰阳性菌及真菌。4种主要革兰阴性菌和3种主要革兰阳性菌对临床常用抗生素均具有一定的耐药性。临床应及时了解患者的病原菌分布情况和耐药性,以选择最合适的抗菌药物,进而提高治疗效果,改善患者预后。

Objective To analyze the pathogen distribution and drug resistance in occult pneumonia,so as to provide a reference basis for the clinical rational use of antibiotics.Methods A total of 118 patients with occult pneumonia treated in our hospital from May 2017 to May 2020 were selected as the research objects.Sputum was collected to analyze the pathogen distribution,and drug sensitivity test was carried out at the same time.Results One hundred and sixty-eight strains of pathogens were isolated from 118 patients with occult pneumonia,including 84 strains of Gram-negative bacteria,accounting for 50.00%,mainly Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae and Escherichia coli,accounting for 42.86%,25.00%,19.05%and 5.95%respectively;58 strains of Gram-positive bacteria,accounting for 34.52%,mainly Staphylococcus aureus,Streptococcus pneumoniae and Streptococcus lactis equine subspecies,accounting for 58.62%,31.03%and 6.90%respectively;26 strains of fungi,accounting for 15.48%,mainly Candida albicans,accounting for 80.77%.The Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae and Escherichia coli had low drug resistance to imipenem.The drug resistance of Staphylococcus aureus,Streptococcus pneumoniae and Streptococcus lactis equine subspecies to vancomycin was 0.00%.Conclusion The pathogens of patients with occult pneumonia are mainly Gram-negative bacteria,and there are also some Gram-positive bacteria and fungi.Four major Gram-negative bacteria and three major Gram-positive bacteria have certain drug resistance to common clinical antibiotics.In order to select the most appropriate antibiotics and improve the treatment effect and prognosis,we should timely understand the pathogen distribution and drug resistance in patients.