黔南民族医专学报
黔南民族醫專學報
검남민족의전학보
JOURNAL OF QIANNAN MEDICAL COLLEGE FOR NATIONAL MINORITIES
2015年
1期
22-25
,共4页
多重耐药菌%相关性肺炎%病原学%抗菌药物
多重耐藥菌%相關性肺炎%病原學%抗菌藥物
다중내약균%상관성폐염%병원학%항균약물
multi-drug resistant bacteria%associated pneumonia%etiology%antimicrobial drugs
目的：分析多重耐药菌感染在老年普外科住院患者相关性肺炎患者中病原学及抗菌药物治疗的耐药率，为临床诊断治疗提供依据。方法：采集医院372例老年普外科住院患者相关性肺炎患者痰液，进行痰培养及药敏试验，探讨其病原菌分布及抗菌药物治疗的耐药率分析。结果：372株病原菌中革兰氏阳性球菌95株，占15.32％；革兰氏阴性杆菌277株，占59.95％；真菌54株，占14.51％；其中常见的革兰氏阳性球菌包括金黄色葡萄球菌、溶血葡萄球菌、表皮葡萄球菌，分别占15.32％、2.96％、4.30％；常见的革兰氏阴性杆菌包括铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌，分别占23.92％、14.25％、9.95％；金黄色葡萄球菌对青霉素、红霉素、苯唑西林耐药率为100.00％，表皮葡萄球菌对红霉素耐药率最高87.50％，溶血葡萄球菌对青霉素、红霉素耐药率最高100.00％，三种主要革兰氏阴性杆菌均对替考西林和万古霉素耐药率最低0％；大肠埃希菌对头孢曲松、替卡西林耐药率最高100.00％，对环丙沙星耐药率最低11.32％；铜绿假单胞菌对头孢曲松耐药率最高100.00％，对亚胺培南耐药率最低22.47％；肺炎克雷伯菌对氨曲南耐药率最高81.08％，对亚胺培南最低0.00％。结论：老年普外科住院患者相关性肺炎患者在临床较为常见，按照其病原学分布及耐药性特点，进行抗菌药物的早期合理选用，同时做好相关的积极防治措施。
目的：分析多重耐藥菌感染在老年普外科住院患者相關性肺炎患者中病原學及抗菌藥物治療的耐藥率，為臨床診斷治療提供依據。方法：採集醫院372例老年普外科住院患者相關性肺炎患者痰液，進行痰培養及藥敏試驗，探討其病原菌分佈及抗菌藥物治療的耐藥率分析。結果：372株病原菌中革蘭氏暘性毬菌95株，佔15.32％；革蘭氏陰性桿菌277株，佔59.95％；真菌54株，佔14.51％；其中常見的革蘭氏暘性毬菌包括金黃色葡萄毬菌、溶血葡萄毬菌、錶皮葡萄毬菌，分彆佔15.32％、2.96％、4.30％；常見的革蘭氏陰性桿菌包括銅綠假單胞菌、大腸埃希菌、肺炎剋雷伯菌，分彆佔23.92％、14.25％、9.95％；金黃色葡萄毬菌對青黴素、紅黴素、苯唑西林耐藥率為100.00％，錶皮葡萄毬菌對紅黴素耐藥率最高87.50％，溶血葡萄毬菌對青黴素、紅黴素耐藥率最高100.00％，三種主要革蘭氏陰性桿菌均對替攷西林和萬古黴素耐藥率最低0％；大腸埃希菌對頭孢麯鬆、替卡西林耐藥率最高100.00％，對環丙沙星耐藥率最低11.32％；銅綠假單胞菌對頭孢麯鬆耐藥率最高100.00％，對亞胺培南耐藥率最低22.47％；肺炎剋雷伯菌對氨麯南耐藥率最高81.08％，對亞胺培南最低0.00％。結論：老年普外科住院患者相關性肺炎患者在臨床較為常見，按照其病原學分佈及耐藥性特點，進行抗菌藥物的早期閤理選用，同時做好相關的積極防治措施。
목적：분석다중내약균감염재노년보외과주원환자상관성폐염환자중병원학급항균약물치료적내약솔，위림상진단치료제공의거。방법：채집의원372례노년보외과주원환자상관성폐염환자담액，진행담배양급약민시험，탐토기병원균분포급항균약물치료적내약솔분석。결과：372주병원균중혁란씨양성구균95주，점15.32％；혁란씨음성간균277주，점59.95％；진균54주，점14.51％；기중상견적혁란씨양성구균포괄금황색포도구균、용혈포도구균、표피포도구균，분별점15.32％、2.96％、4.30％；상견적혁란씨음성간균포괄동록가단포균、대장애희균、폐염극뢰백균，분별점23.92％、14.25％、9.95％；금황색포도구균대청매소、홍매소、분서서림내약솔위100.00％，표피포도구균대홍매소내약솔최고87.50％，용혈포도구균대청매소、홍매소내약솔최고100.00％，삼충주요혁란씨음성간균균대체고서림화만고매소내약솔최저0％；대장애희균대두포곡송、체잡서림내약솔최고100.00％，대배병사성내약솔최저11.32％；동록가단포균대두포곡송내약솔최고100.00％，대아알배남내약솔최저22.47％；폐염극뢰백균대안곡남내약솔최고81.08％，대아알배남최저0.00％。결론：노년보외과주원환자상관성폐염환자재림상교위상견，안조기병원학분포급내약성특점，진행항균약물적조기합리선용，동시주호상관적적겁방치조시。
Objective:To analyze the etiology and the antimicrobial resistance rate of multi-drug re-sistant infection in elderly inpatients with associated pneumonia in the department of general surgery,so as to provide reference for clinical diagnosis and treatment. Methods:Sputum samples were collected from 372 elderly inpatients with associated pneumonia in the department of general surgery for sputum culture and sensi-tivity test to investigate the distribution of pathogens and the resistance rate to antimicrobial treatment. Re-sults:Among the 372 pathogens,there were 95 strains of gram-positive cocci,accounting for 15.32%;277 strains of gram-negative bacilli,accounting for 59.95%;54 strains of fungi,accounting for 14.5 1%. The common gram-positive cocci included Staphylococcus aureus,hemolytic Staphylococcus aureus,and Staphy-lococcus epidermidis,accounting for 15.32%,2.96%,and 4.30%. The common gram-negative bacteria included Pseudomonas aeruginosa,Escherichia coli,and Klebsiella pneumoniae,accounting for 23.92%,14.25%,and 9.95%. The resistance rate of Staphylococcus aureus to penicillin,erythromycin, benzene cloxacillin was 100.00%. The resistance rate of Staphylococcus epidermidis to erythromycin was up to 87.50%,and that of hemolytic Staphylococci to penicillin and erythromycin was up to 100.00%. Three major gram-negative bacilli showed the lowest resistance of 0%to Teicocillin. Escherichia coli had the high-est resistance rate of 100.00%to ceftriaxone and ticarcillin and the lowest resistance rate of 1 1.32%to cipro-floxacin. Pseudomonas aeruginosa had the highest resistance rate of 100.00%to ceftriaxone and the lowest re-sistance rate of 22.47%to imipenem. Klebsiella pneumoniae had the highest resistance rate of 8 1.08%to az-treonam and the lowest resistance rate of 0.00% to imipenem. Conclusion:Associated pneumonia is com-monly seen in elderly patients in the department of general surgery. Early rational use of antimicrobial drugs should be conducted for these patients according to pathogen distribution and drug resistance characteristics, meanwhile,relevant positive control measures should be taken.
