医院获得性肺炎患者的病原菌分布及耐药率分析

发布时间：2018-07-08 16:33

本文选题：医院获得性肺炎 + 病原菌分布　；参考：《中华医院感染学杂志》2017年13期

【摘要】：目的探讨发生医院获得性肺炎(HAP)患者的病原菌分布和耐药率情况以及血清钠水平和C-反应蛋白指标的变化,为临床预防治疗提供研究依据。方法选取2012年4月-2016年10月2470例住院患者为研究对象,将发生肺炎情况进行统计,并对病原菌进行分离鉴定,以药敏试验分析其耐药情况,同时检测患者的血清钠水平和C-反应蛋白指标的变化。结果 2470例住院患者中有132例为HAP,感染率为5.34%;132例HAP患者共检出病原菌258株,其中革兰阴性菌134株占51.94%、革兰阳性菌106株占41.08%、真菌18株占6.98%,药敏试验显示:铜绿假单胞菌和鲍氏不动杆菌对亚胺培南、头孢哌酮/他巴唑和哌拉西林的耐药率较低,对头孢曲松和庆大霉素耐药率较高;革兰阳性菌以耐甲氧西林的金葡菌42株占16.28%和凝固酶阴性葡萄球菌28株占10.85%居多,对万古霉素、替考拉宁的耐药率较低,对氨苄西林和青霉素的耐药率较高;HAP患者的血清钠水平(110.16±8.76)mmol/L和C-反应蛋白(143.49±26.07)mg/L指标较其他非感染肺炎患者明显降低和升高,差异有统计学意义(P0.05)。结论医院获得性肺炎患者的主要致病菌为革兰阴性菌,患者的血清钠水平降低和C-反应蛋白升高明显,经过药敏试验明确感染菌的耐药情况,为临床治疗中选择敏感度高的抗菌药物提供科学依据。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and the rate of drug resistance in patients with hospital acquired pneumonia (HAP), the changes of serum sodium level and C- reactive protein index, and to provide the basis for clinical prevention and treatment. Methods 2470 cases of hospitalized patients in October of April 2012 were selected as the research image, and the pneumonia situation was counted, and the pathogens were analyzed. The bacteria were isolated and identified by the drug sensitivity test, and the changes of serum sodium and C- reaction protein were detected in the patients. Results 132 of the 2470 hospitalized patients were HAP, and the infection rate was 5.34%. 132 cases of HAP patients detected 258 pathogenic bacteria, 134 of Gram-negative bacteria were 51.94%, and 106 of Gram-positive bacteria were 41.08%, 18 strains of fungi accounted for 6.98%. The drug sensitivity test showed that the resistance rate of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem, Cefoperazone / triazol and piperacillin was lower, and the resistance rate to ceftriaxone and gentamicin was higher; Gram-positive bacteria 42 strains of methicillin resistant Staphylococcus aureus and 28 coagulase negative Staphylococcus were 10.85%. The drug resistance rate of vancomycin and teicoplanin was low, and the resistance rate to ampicillin and penicillin was higher. The serum sodium level (110.16 + 8.76) mmol/L and C- reactive protein (143.49 + 26.07) mg/L in patients with HAP were significantly lower and higher than those of other non infected pneumonia patients. The difference was statistically significant (P0.05). Conclusion the hospital acquired lung The main pathogenic bacteria of the patients were Gram-negative bacteria, the level of serum sodium and the increase of C- reaction protein were obvious. The drug sensitivity test was used to provide a scientific basis for the selection of antimicrobial agents with high sensitivity in clinical treatment.
【作者单位】：河南科技大学第一附属医院药剂科;
【分类号】：R446.5;R563.1

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