新疆部分地区成人社区获得性肺炎诊疗现况及病原学调查

发布时间：2018-10-12 12:40

【摘要】：目的:调查本院急诊科成人社区获得性肺炎诊疗现况及病原学特点,为本地区成人CAP治疗提供参考。方法:纳入2015年10月-2016年10月就诊于我院急诊科的住院成人CAP患者共124人,使用抗生素前留取痰培养,记录细菌培养、耐药性结果,并完善患者基本情况,入院首次血液检查结果,治疗情况及预后等基线资料。统计学采用SPSS21.0软件,计数资料采用X2检验。结果:我院急诊科就诊的成人社区获得性肺炎患者以老年患者为主,平均年龄65.37±16.688岁,男性患者多于女性患者,男女性别比为1.58:1。入院后93.5%的患者24小时内得到抗感染治疗,初始治疗最常用的抗生素为β-内酰胺类54.8%、呼吸喹诺酮类30.6%为主;124例患者中共48例(38.7%)痰培养培养出致病菌。培养前三位分别为肺炎克雷伯菌11例,肺炎链球菌9例,大肠埃希菌8例。肺炎克雷伯菌、肺炎链球菌均对β内酰胺类、呼吸喹诺酮类及三代头孢类抗生素敏感性高,对二代头孢菌素敏感性低。结论:本院急诊科住院的成人CAP患者以老年患者为主,肺部感染体征不明显,常多伴随各种基础疾病,病原学构成类似老年CAP致病菌谱分布,对β内酰胺类、呼吸喹诺酮类敏感性较好。
[Abstract]:Objective: to investigate the diagnosis and treatment status and etiological characteristics of adult community-acquired pneumonia (CAP) in emergency department of our hospital. Methods: from October 2015 to October 2016, 124 adult CAP patients were admitted to our emergency department. Sputum culture was retained before antibiotic use, bacterial culture and drug resistance were recorded, and the basic conditions of the patients were improved. The results of first blood examination, treatment and prognosis were baseline data. SPSS21.0 software was used in statistics and X 2 test was used for counting data. Results: the majority of adult community-acquired pneumonia patients in our hospital were aged 65.37 卤16.688 years old, male patients were more than female patients, the ratio of male to female was 1.58: 1. 93.5% of the patients received anti-infection treatment within 24 hours after admission. The most commonly used antibiotics in the initial treatment were 尾 -lactam 54.8and respiratory quinolones 30.6%, and there were 48 (38.7%) sputum cultures of pathogenic bacteria in 124 patients. The first three were Klebsiella pneumoniae (11 cases), Streptococcus pneumoniae (9 cases) and Escherichia coli (8 cases). Klebsiella pneumoniae and Streptococcus pneumoniae were highly sensitive to 尾 -lactam, respiratory quinolones and third-generation cephalosporins, but low to second-generation cephalosporins. Conclusion: adult CAP patients in the emergency department of our hospital are mainly elderly patients, pulmonary infection signs are not obvious, often accompanied by a variety of basic diseases, etiology is similar to the distribution of geriatric CAP pathogens, 尾 -lactam. The respiratory quinolones were sensitive.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R563.1

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