[1]刘雪健,胡静雯,廖明喻,等.细菌性重症肺炎病原学特征及药物敏感性分析[J].青岛大学学报(医学版),2018,54(04):461-464.[doi:10.11712/jms201804021]
 LIU Xuejian,HU Jingwen,LIAO Mingyu,et al.ANALYSIS OF PATHOGENIC MICROORGANISMS AND DRUG SENSITIVITY IN SEVERE BACTERIAL PNEUMONIA[J].JOURNAL OF QINGDAO UNIVERSITY (MEDICAL SCIENCES),2018,54(04):461-464.[doi:10.11712/jms201804021]
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细菌性重症肺炎病原学特征及药物敏感性分析()
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《青岛大学学报(医学版)》[ISSN:2096-5532/CN:37-1217/R]

卷:
第54卷
期数:
2018年04期
页码:
461-464
栏目:
出版日期:
2018-07-05

文章信息/Info

Title:
ANALYSIS OF PATHOGENIC MICROORGANISMS AND DRUG SENSITIVITY IN SEVERE BACTERIAL PNEUMONIA
文章编号:
2096-5532(2018)04-0461-04
作者:
刘雪健胡静雯廖明喻焦光宇
(中国医科大学附属盛京医院呼吸内科,辽宁 沈阳 110004)
Author(s):
LIU Xuejian HU Jingwen LIAO Mingyu JIAO Guangyu
(Respiratory Medicine, Shengjing Hospital, China Medical University, Shenyang 110004, China)
关键词:
肺炎细菌性病原微生物敏感性试验
Keywords:
pneumonia bacterial noxae microbial sensitivity tests
分类号:
R563.19
DOI:
10.11712/jms201804021
文献标志码:
A
摘要:
目的 分析重症肺炎病人的病原菌特征及药物敏感性,指导临床合理使用抗菌药物。
方法 回顾性分析2014—2016年我院呼吸科住院重症肺炎病人痰、血液、支气管肺泡灌洗液、胸水微生物培养结果及药敏试验结果。
结果 265例重症肺炎病人病原学阳性155例,阳性率58.49%。649份合格痰液标本,病原学阳性238份(36.67%),其中细菌176株(73.95%),阳性率前4位的细菌分别为鲍曼不动杆菌78株(44.31%)、铜绿假单胞菌50株(28.41%)、肺炎克雷伯杆菌17株(9.66%)、金黄色葡萄球菌10株(5.68%)。597份血液标本细菌培养阳性77份,阳性率12.90%,其中细菌73株(94.81%),阳性率前4位的细菌分别为肺炎克雷伯杆菌14株(19.18%)、铜绿假单胞菌8株(10.96%)、金黄色葡萄球菌8株(10.96%)、鲍曼不动杆菌7株(9.59%)。31份胸水标本细菌培养阳性3例(9.68%),其中鲍曼不动杆菌2株(66.70%),金黄色葡萄球菌1株(33.30%)。支气管肺泡灌洗液细菌培养8例,培养出铜绿假单胞菌1株。鲍曼不动杆菌、铜绿假单胞菌对常用抗菌药耐药率高,其余病原微生物均有不同程度耐药;铜绿假单胞菌对妥布霉素耐药性逐年增加;鲍曼不动杆菌对绝大多数药物耐药率均>80%,对阿米卡星及替加环素较为敏感,且耐药性逐年下降。
结论 重症肺炎病人的病原菌以革兰阴性菌为主,革兰阳性细菌以葡萄球菌为主。
Abstract:
Objective To analyze the pathogenic microorganisms and drug sensitivity in severe pneumonia and to guide the rational use of antimicrobial agents for this disease in clinical practice.
Methods A retrospective analysis was performed on the microbial culture results of sputum, blood, bronchoalveolar lavage fluid, and pleural effusion and drug sensitivity test results in 265 patients with severe pneumonia who were admitted to the Department of Respiratory Medicine in our hospital from 2014 to 2016.
Results Among the 265 patients,155 (58.49%) were positive for pathogenic microorganisms. Among the 649 qualified sputum samples, 238 (36.67%) were positive for pathogenic microorganisms, of which,176 (73.95%) were positive for bacteria. The top four positive bacteria were Acinetobacter baumannii (78/176,44.31%), Pseudomonas aeruginosa (50/176,28.41%), Klebsiella pneumonia (17/176,9.66%), and Staphylococcus aureus (10/176,5.68%). Among the 597 blood samples, 77 (12.90%) were positive for pathogenic microorganisms, of which,73 (94.81%) were positive for bacteria. The top four positive bacteria were Klebsiella pneumonia (14/73,19.18%), Pseudomonas aeruginosa (8/73,10.96%), Staphylococcus aureus (8/73,10.96%), and Acinetobacter baumannii (7/73,9.59%). Three (9.68%) out of 31 pleural effusion samples were positive for bacteria, including Acinetobacter baumannii (2/3,66.70%) and Staphylococcus aureus (1/3,33.30%). Eight bronchoalveolar lavage fluid samples were positive for bacteria, of which,1 (12.50%) was positive for Pseudomonas aeruginosa. The resistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa to common antimicrobial agents were high, and other pathogenic microorganisms showed varying degrees of resistance to common antimicrobial agents. The resistance of Pseudomonas aeruginosa to tobramycin increased year by year. The resistance rate of Acinetobacter baumannii to most antimicrobial agents were>80%, it was more sensitive to amikacin and tigecycline, and its drug resistance decreased year by year.
Conclusion The pathogenic bacteria of severe pneumonia are mainly Gram-negative bacteria, and Gram-positive bacteria are mainly Staphylococcus.
更新日期/Last Update: 2018-07-08