CAJ | 학술논문

目的：探讨基层医院社区获得性肺炎（CAP）患者的病原学分布情况和常见细菌的耐药性，为基层医院CAP的治疗提供依据。方法选择2010年1月—2013年12月在我院住院治疗的 CAP患者360例，对患者的呼吸道分泌物进行病原学培养，分离鉴别细菌，并进行药物敏感性试验；同时检测患者急性期、恢复期肺炎支原体、肺炎衣原体抗体水平。结果186例（51．67％）CAP患者病原学检测阳性，其中18．82％为混合感染，位于前4位的病原体为肺炎支原体、流感嗜血杆菌、肺炎克雷伯菌、肺炎链球菌及肺炎衣原体。流感嗜血杆菌对氨苄西林的耐药率为42.85％。肺炎克雷伯菌对氨苄西林和部分第三代头孢耐药；青霉素耐药的肺炎链球菌株（PRSP）为29．17％，肺炎链球菌对阿莫西林、头孢曲松等敏感率高。结论流感嗜血杆菌、肺炎克雷伯菌和肺炎链球菌是 CAP最常见的致病细菌，但非典型病原体也在CAP中占据重要地位，对各种常用抗菌药物有不同的耐药性。
목적：탐토기층의원사구획득성폐염（CAP）환자적병원학분포정황화상견세균적내약성，위기층의원CAP적치료제공의거。방법선택2010년1월—2013년12월재아원주원치료적 CAP환자360례，대환자적호흡도분비물진행병원학배양，분리감별세균，병진행약물민감성시험；동시검측환자급성기、회복기폐염지원체、폐염의원체항체수평。결과186례（51．67％）CAP환자병원학검측양성，기중18．82％위혼합감염，위우전4위적병원체위폐염지원체、류감기혈간균、폐염극뢰백균、폐염련구균급폐염의원체。류감기혈간균대안변서림적내약솔위42.85％。폐염극뢰백균대안변서림화부분제삼대두포내약；청매소내약적폐염련구균주（PRSP）위29．17％，폐염련구균대아막서림、두포곡송등민감솔고。결론류감기혈간균、폐염극뢰백균화폐염련구균시 CAP최상견적치병세균，단비전형병원체야재CAP중점거중요지위，대각충상용항균약물유불동적내약성。
Objective To investigate the pathogenic causes of community acquired pneumonia(CAP)and to guide experiencw antibiotic therapy in primary hospital.Methods A pretrospective analysis was conducted on the hospital-izedpatients with CAP from January 2010 to December 2013 in primary hospital and 360 patients seleceted.The respira-tory tract secretions for bacterial culture,drug sensitivity test were separated and identified the bacteria,at the same time detection in patients with acute period and recovery period of mycoplasma pneumoniae,chlamydia pneumoniae anti-body.Results 186 (51.64%)was detected Positive,18.82% was mixed infection,in the top 4 were Mycoplasma pneu-moniae、Haemophilus influenzae、Klebsiella pneumoniae、Streptococcus pneumoniae、Chlamydia pneumoniae.Haemophi-lus influenzae resistant to ampicillin was 42.85%.Klebsiella pneumoniae resistance to ampicillin,part of the third gen-eration cephalosporin.PRSP was 29.17%.Conclusion Haemophilus influenzae,Klebsiella pneumoniae and Streptococ-cus pneumoniae is the most common pathogenic bacteria in CAP,but atypical pathogens in the CAP occupy an impor-tant position,there is different resistance in a variety of commonly used antimicrobial agents,this study can provide a reliable basis for the treatment of CAP.