临床肺科杂志
臨床肺科雜誌
림상폐과잡지
JOUNAL OF CLINICAL PULMONARY MEDICINE
2015年
4期
679-681
,共3页
肺炎病原菌%分布%耐药率
肺炎病原菌%分佈%耐藥率
폐염병원균%분포%내약솔
pneumonia pathogenic bacteria%distribution%drug resistance rate
目的：研究肺炎患者的病原菌分布及耐药性，为临床治疗肺炎提供合理化的用药依据。方法分析医院2013年1月至2013年12月肺炎患者痰液标本以及上呼吸道分泌物标本中分离的病原菌，采用法国梅里埃VITEK2全自动细菌鉴定及药敏分析仪进行检测。结果肺炎患者504株病原菌中，鲍曼不动杆菌的分离率居160株首位，达31．75%，其次为铜绿假单胞菌115株(22．82%)，肺炎克雷伯菌73株(14．48%)，大肠埃希菌50株(9．92%)以及金黄色葡萄球菌29株(5．75%)。其中鲍曼不动杆菌和铜绿假单胞菌对氨苄西林/舒巴坦、头孢呋辛和头孢曲松耐药率>70%，头孢哌酮/舒巴坦耐药率<15%，可作为严重感染时的经验用药。肺炎克雷伯菌和大肠埃希菌对哌拉西林、氨苄西林/舒巴坦、头孢呋辛、头孢曲松、头孢吡肟和氨曲南耐药率>50%，亚胺培南和美罗培南100%敏感。金黄色葡萄球菌对青霉素、红霉素耐药率很高， MRSA检出率34．5%，万古霉素和利奈唑烷100%敏感。结论加强对医院肺炎的细菌学检测和耐药性分析，根据药敏结果合理选择抗菌药物以提高肺炎患者的治愈率。
目的：研究肺炎患者的病原菌分佈及耐藥性，為臨床治療肺炎提供閤理化的用藥依據。方法分析醫院2013年1月至2013年12月肺炎患者痰液標本以及上呼吸道分泌物標本中分離的病原菌，採用法國梅裏埃VITEK2全自動細菌鑒定及藥敏分析儀進行檢測。結果肺炎患者504株病原菌中，鮑曼不動桿菌的分離率居160株首位，達31．75%，其次為銅綠假單胞菌115株(22．82%)，肺炎剋雷伯菌73株(14．48%)，大腸埃希菌50株(9．92%)以及金黃色葡萄毬菌29株(5．75%)。其中鮑曼不動桿菌和銅綠假單胞菌對氨芐西林/舒巴坦、頭孢呋辛和頭孢麯鬆耐藥率>70%，頭孢哌酮/舒巴坦耐藥率<15%，可作為嚴重感染時的經驗用藥。肺炎剋雷伯菌和大腸埃希菌對哌拉西林、氨芐西林/舒巴坦、頭孢呋辛、頭孢麯鬆、頭孢吡肟和氨麯南耐藥率>50%，亞胺培南和美囉培南100%敏感。金黃色葡萄毬菌對青黴素、紅黴素耐藥率很高， MRSA檢齣率34．5%，萬古黴素和利奈唑烷100%敏感。結論加彊對醫院肺炎的細菌學檢測和耐藥性分析，根據藥敏結果閤理選擇抗菌藥物以提高肺炎患者的治愈率。
목적：연구폐염환자적병원균분포급내약성，위림상치료폐염제공합이화적용약의거。방법분석의원2013년1월지2013년12월폐염환자담액표본이급상호흡도분비물표본중분리적병원균，채용법국매리애VITEK2전자동세균감정급약민분석의진행검측。결과폐염환자504주병원균중，포만불동간균적분리솔거160주수위，체31．75%，기차위동록가단포균115주(22．82%)，폐염극뢰백균73주(14．48%)，대장애희균50주(9．92%)이급금황색포도구균29주(5．75%)。기중포만불동간균화동록가단포균대안변서림/서파탄、두포부신화두포곡송내약솔>70%，두포고동/서파탄내약솔<15%，가작위엄중감염시적경험용약。폐염극뢰백균화대장애희균대고랍서림、안변서림/서파탄、두포부신、두포곡송、두포필우화안곡남내약솔>50%，아알배남화미라배남100%민감。금황색포도구균대청매소、홍매소내약솔흔고， MRSA검출솔34．5%，만고매소화리내서완100%민감。결론가강대의원폐염적세균학검측화내약성분석，근거약민결과합리선택항균약물이제고폐염환자적치유솔。
Objective To study the distribution and drug resistance of pathogens in patients with pneumoni-a, in order to provide reasonable medication basis for clinical treatment of pneumonia. Methods The sputum of pa-tients with pneumonia and upper respiratory tract secretions were detected by the French bioMerieux VITEK2 automat-ic bacteria identification and drug sensitivity analysis. Results 504 strains of pathogenic bacteria were isolated, which included 31. 75% of Bauman acinetobacter, 115 strains of Pseudomonas aeruginosa (22. 82%), 73 strains of Klebsiella pneumoniae (14. 48%), 50 strains of Escherichia coli (9. 92%) and 29 strains of Staphylococcus aureus (5. 75%). The drug-resistance of Bauman acinetobacter and Pseudomonas aeruginosa to ampicillin/sulbactam, cefu-roxime and ceftriaxone was higher than 70%, and to cefoperazone/sulbactam was lower than 15%. The drug-resist-ance of Escherichia coli and Klebsiella pneumoniae to piperacillin, ampicillin/sulbactam, cefuroxime, ceftriaxone, cefepime and aztreonam was higher than 50%, but 100% sensitive to imipenem and meropenem. The drug-resistance of Staphylococcus aureus to penicillin and erythromycin was 34. 5%, but 100% sensitive to vancomycin and linezol-id. Conclusion The curative rate can be improved by strengthening the bacteriological detection and analysis of drug resistance of nosocomial pneumonia, and reasonable selection of antimicrobial agents according to the results.
