医院与社区获得性肺炎的病原菌分布及耐药性

发布时间：2018-10-30 09:29

【摘要】：目的通过比较医院与社区获得性肺炎的病原菌分布及耐药性,以指导临床医师对不同类型的肺炎合理使用抗菌药物,为经验使用抗菌药物提供有效依据。方法回顾性分析2009-2012年住院患者医院与社区获得性肺炎的病原菌分布及耐药性,采用MicroScanAutoScan-40半自动微生物鉴定仪和药敏系统等进行菌株鉴定与药物敏感性测定,采用WHONET5软件进行数据统计分析。结果医院获得性肺炎共检出病原菌252株,其中革兰阴性杆菌204株占80.9%;社区获得性肺炎检出病原菌518株,其中革兰阴性杆菌366株占70.7%,医院获得性肺炎检出病原菌中革兰阴性杆菌所占比例明显大于社区获得性肺炎;主要革兰阴性杆菌对哌拉西林/他唑巴坦、亚胺培南、阿米卡星耐药率均15.0%;主要革兰阳性球菌对万古霉素、哌拉西林/他唑巴坦、阿莫西林/克拉维酸、苯唑西林耐药率均12.0%;医院获得性肺炎大肠埃希菌对第三代头孢菌素及氨曲南的耐药率明显高于社区获得性肺炎。结论医院获得性肺炎与社区获得性肺炎的病原菌以革兰阴性菌为主,监测并比较二者病原菌分布及耐药性,可为其经验性选择抗菌药物提供可靠数据资料。
[Abstract]:Objective to compare the distribution and drug resistance of pathogenic bacteria between hospital and community acquired pneumonia in order to guide clinicians to use antibiotics rationally for different types of pneumonia and to provide effective evidence for experience in using antibiotics. Methods the distribution and drug resistance of pathogenic bacteria in hospital and community acquired pneumonia from 2009 to 2012 were analyzed retrospectively. The bacterial strain identification and drug sensitivity were determined by MicroScanAutoScan-40 semi-automatic microbiological identification instrument and drug sensitivity system. The data were analyzed by WHONET5 software. Results 252 strains of pathogenic bacteria were detected in hospital acquired pneumonia, of which 204 strains were Gram-negative bacilli (80.9%). 518 strains of pathogens were detected in community acquired pneumonia, of which 366 strains were Gram-negative bacilli, and the proportion of Gram-negative bacilli in hospital acquired pneumonia was significantly higher than that in community-acquired pneumonia. The resistance rates of main gram-negative bacilli to piperacillin / tazobactam, imipenem and amikacin were 15.0; The resistance rates of major gram-positive cocci to vancomycin, piperacillin / tazobactam, amoxicillin / clavulanic acid and oxacillin were 12.0; The drug resistance of Escherichia coli to third generation cephalosporins and aztreonam was significantly higher than that of community-acquired pneumonia. Conclusion Gram-negative bacteria are the main pathogens of hospital acquired pneumonia and community acquired pneumonia. Monitoring and comparing the distribution and drug resistance of the two pathogens can provide reliable data for the empirical selection of antibiotics.
【作者单位】：广西医科大学第四附属医院呼吸内科;
【基金】：广西壮族自治区科学技术厅基金项目(桂科攻1140003A-43)
【分类号】：R446.5;R563.1

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