重症社区获得性肺炎的病原学及药物敏感性研究

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1、重症社区获得性肺炎的病原学及药物敏感性研究作者：肖玲郑忠生郑小河余文聘陈潮钦吴洁文【关键词】重症摘要：目的：探讨本地区重症社区获得性肺炎的病原学与药敏特点，为合理使用抗生素提供依据。方法：采用VITEK-AMS微生物分析仪测定病原菌，并用纸片法测定病原菌的体外药物敏感性。结果：69例患者，年龄20～95岁，平均65±18岁，≥65岁49例，占%。%患者有基础疾病，其中慢性阻塞性肺病最常见。临床表现为咳嗽，咳黄脓痰，肺部出现湿罗音，高热，意识障碍。所有患者进行了病原学检查，50例患者培养出54株细菌，17例合并真菌感染；54株细菌中革兰阳性需氧菌13株，以葡萄球菌属为主，占12株；革兰阴

2、性杆菌41株，以铜绿假单胞菌为主，占11株，嗜麦芽窄食单胞菌9株，肠杆菌科8株。铜绿假单胞菌依次对头孢派酮钠/舒巴坦钠、特治星及泰能敏感；肠杆菌科对泰能、头孢派酮钠/舒巴坦钠与特治星敏感。治愈31例，好转10例，自动出院12例，死亡16例。结论：SCAP多发生于老年人；病原体中革兰阴性菌占%，以铜绿假单胞菌为主，其次是嗜麦芽窄食单胞菌，革兰阳性需氧菌占24%，以葡萄球菌属为主；入院初期经验治疗应选择广谱的强有力抗菌素，再根据病原体检测结果改用针对性强、窄谱的抗菌药物。关键词：重症社区获得性肺炎；铜绿假单胞菌；病原学；药物敏感性StudytheCharacteristicsofEtiol

3、ogyandDrugSensitivityAboutSeriousCommunityAcquiredPneumoniaAbstract:Objective:Toinvestigatethepathogenandantibioticsensitivityofseriouscommunityacquiredpneumonia(SCAP)inourhospitalandtoevaluatetheclinicalcharacteristicsofSCAP,aimingatprovidingevidenceforusingantibiotic.Method:Thebacteriaweretest

4、edwithVITEK-AMS,andthedrugsensitivityagainstbacteriabyK-Bmethodwasstudied.Result:Thereweremalesand1females,themeanagebEing5±%ofcaseshadunderlyingdiseases,mostofwhichwereCOPD.Clinicalmanifestationsincludedcough(100%),purulentsputum(%),bubble(100%),hyperpyrexia(%)andconsciousdisturbance(%).Therewe

5、restrainsbacteriaof0casesthroughsputumculture,and17caseswerecomplicatedwithfungus.Gram-positivebacteriawere1stains,mostofwhichwerestaphylococci.Gram-negativebacteriawere1strains,including11strainsofpseudomonasaeruginosa,strainsofxanthomonasmaltophilia,strainsofenterobacterianceae,andsoon.Thedrug

6、sensitivityratetowardspseudomonasaeruginosawassulperazone8%,tazocin5%andtienam0%respectively.Thattowardsenterobacterianceaewas%,%and%%caseswerehealing.%wereimproved.%quittedtreatment%werefatality.Conclusion:SCAPeasyoccurredintheagedpeople.Thepathogenofsputum%ofgram-negativebacteria%ofgram-positi

7、vebacteria.Themajorofgram-egativebacteriawaspseudomonasaeruginosa,andthemainofgram-positivebacteriawasstaphylococci.Itwasreasonabletoelectpowerfulandbroad-spectrumantibioticintheinitiallyexperientialtherapy,thenusethestronga