重症肺炎患者多重耐药菌感染的病原菌分布及耐药性分析

Pathogen Distribution and Drug Resistance Analysis of Multidrugresistant Bacteria Infection in Patients with Severe Pneumonia

目的:分析重症肺炎患者多重耐药菌感染的病原菌分布特点,并对主要的病原菌耐药性进行探讨。方法:回顾性分析2019年1月—2023年12月本院收治120例重症肺炎多重耐药菌感染患者资料,全部患者均接受痰液标本痰培养与药敏试验,并对痰培养结果与药敏试验结果进行分析。结果:本研究检出多重耐药细菌154株,其中革兰氏阴性菌占比较高,为72.08%(111/154)。鲍曼不动杆菌对哌拉西林-他唑巴坦、哌拉西林耐药性最高,对黏菌素、头孢地尔最敏感;铜绿假单胞菌对亚胺培南耐药性最高,对黏菌素最敏感;肺炎克雷伯菌对头孢哌酮-舒巴坦、左氧氟沙星耐药性最高,对黏菌素、头孢地尔最敏感;金黄色葡萄球菌对青霉素、红霉素的耐药率相对较高,其中青霉素的耐药率最高,且对万古霉素、磷霉素、利福平、苯唑西林、替考拉宁、替加环素、去甲万古霉素等药物均较敏感。结论:重症肺炎患者多重耐药菌感染的病原菌以革兰氏阴性菌为主;且对抗菌药物耐药性普遍较高,临床应加强主要致病菌的耐药性检测,针对性选择敏感度较高的药物,以增强治疗效果。

Objective:To analyze the distribution characteristics of pathogenic bacteria in patients with severe pneumonia infected with multidrug-resistant bacteria,and to explore the drug resistance of the main pathogenic bacteria.Methods:The data of 120 patients with severe pneumonia and multidrug-resistant bacteria infection admitted to the hospital from January 2019 to December 2023 were retrospectively analyzed.All patients received sputum culture and drug sensitivity test of sputum specimens,and the results of sputum culture and drug sensitivity test were analyzed.Results:In this study,154 strains of multidrug-resistant bacteria were detected,of which Gram-negative bacteria accounted for 72.08%(111/154).Acinetobacter baumannii had the highest resistance to piperacillin-tazobactam and piperacillin,and was most sensitive to colistin and cefodil.Pseudomonas aeruginosa had the highest resistance to imipenem and the most sensitive to colistin.Klebsiella pneumoniae had the highest resistance to cefoperazonesulbactam and levofloxacin,and was most sensitive to colistin and cefodil.The resistance rate of Staphylococcus aureus to penicillin and erythromycin was relatively high,among which penicillin had the highest resistance rate,and it was sensitive to vancomycin,fosfomycin,rifampicin,oxacillin,teicoplanin,tigecycline,norvancomycin and other drugs.Conclusion:The pathogenic bacteria of multidrug-resistant bacteria infection in patients with severe pneumonia were mainly Gram-negative bacteria.Moreover,the drug resistance to antibiotics is generally high.Clinically,the detection of drug resistance of main pathogenic bacteria should be strengthened,and drugs with higher sensitivity should be selected in a targeted manner to enhance the therapeutic effect.