医院获得性肺炎多重耐药菌感染的易感因素及耐药性分析

发布时间：2018-03-21 07:04

本文选题：医院获得性肺炎　切入点：耐药性　出处：《中国现代医学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的分析医院获得性肺炎患者多重耐药菌感染的耐药性及其易感因素。方法选取2012年1月-2015年12月收治的558例医院获得性肺炎患者资料,通过痰标本的检验结果将其分为多重耐药组和非多重耐药组。观察多重耐药菌感染的检出及构成情况并进行细菌耐药性分析,同时对患者发生多重耐药的易感因素进行统计学分析。结果558例肺炎患者痰标本,检出多重耐药菌(MDRO)株232例,检出率41.6%。其中革兰阳性菌63株占27.1%革兰阴性菌169株占72.9%。主要的革兰阴性菌种有铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌及大肠埃希菌等;主要的革兰阳性菌种有金黄色葡萄球菌,肺炎链球菌和粪肠球菌等。检测出的多重耐药菌对多种常用抗菌药物耐药率较高。患者应用抗菌药物的种类、合并慢性肺部疾病、合并心血管疾病、侵入性操作和使用呼吸机等均是多重耐药菌感染的易感因素。结论医院获得性肺炎患者的多重耐药菌感染发生率较高,且容易对常用抗菌药物发生耐药,临床医生应根据患者的易感因素,防止或减少多重耐药菌引起医院内感染的发生,并根据药敏结果合理选择敏感的抗菌药物进行治疗。
[Abstract]:Objective to analyze the drug resistance and risk factors of multidrug resistant bacteria infection in patients with nosocomial pneumonia. Methods 558 patients with nosocomial pneumonia from January 2012 to December 2015 were selected. The sputum specimens were divided into multidrug resistant group and non multidrug resistant group. The detection and composition of multidrug resistant bacteria infection were observed and the bacterial drug resistance was analyzed. At the same time, the susceptible factors of multidrug resistance in patients were analyzed statistically. Results among 558 sputum samples of pneumonia patients, 232 strains of MDRO-multidrug resistant bacteria were detected. The positive rate of gram-positive bacteria was 41.6. Among them, 63 Gram-positive bacteria accounted for 27.1% Gram-negative bacteria, which accounted for 72.9%. The main Gram-negative strains were Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae and Escherichia coli. The main gram-positive strains are Staphylococcus aureus, Streptococcus pneumoniae, Enterococcus faecalis and so on. The multidrug resistant bacteria detected are relatively high in resistance to various commonly used antimicrobial agents. The risk factors of multidrug resistant bacteria infection were cardiovascular disease, invasive operation and ventilator. Conclusion the incidence of multidrug resistant bacteria infection in patients with nosocomial pneumonia is higher, and it is easy to develop drug resistance to commonly used antimicrobial agents. According to the susceptible factors of the patients, the clinicians should prevent or reduce the incidence of nosocomial infection caused by multidrug resistant bacteria, and reasonably select sensitive antimicrobial agents for treatment according to the results of drug sensitivity.
【作者单位】：广东省汕头市潮阳区大峰医院呼吸内科;
【分类号】：R446.5;R563.1

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