摘要
目的分析医院获得性肺炎病原菌分布及其耐药性,探讨其相关危险因素,为临床诊治提供依据。方法选取2012年2月-2013年7月医院收治的医院获得性肺炎患者作为研究对象,将其根据医院获得性肺炎发生的时间、病情严重程度、抗菌药物应用与否进行分析,并分析下呼吸道分泌物培养病原菌分布及其耐药性,采用WHONET5软件进行统计分析,探讨发生医院获得性肺炎的相关危险因素。结果共发生医院获得性肺炎67例,发生率0.94%;共分离出79株病原菌,其中革兰阳性菌28株占35.44%,革兰阴性菌51株占64.56%;金黄色葡萄球菌对氨苄西林、庆大霉素、磺胺甲噁唑/甲氧苄啶耐药率>60.00%,铜绿假单胞菌对氨苄西林和磺胺甲噁唑/甲氧苄啶耐药率>70.00%,不动杆菌属对氨苄西林、头孢呋辛、头孢曲松和庆大霉素耐药率>65.00%;医院获得性肺炎与侵入性操作、抗菌药物使用、糖尿病、年龄和住院时间相关。结论医院获得性肺炎与多种因素有关,针对患者实际情况,采取适宜的干预措施,可有效降低医院获得性肺炎的发生。
OBJECTIVE To analyze the distribution and drug resistance of pathogenic bacteria causing hospital-acquired pneumonia and explore the related risk factors so as to guide the clinical diagnosis and treatment. METHODS The patients with hospital-acquired pneumonia who were treated in the hospital from Feb 2012 to Jul 2013 were enrolled in the study, then the time of onset of hospital-acquired pneumonia, severity of disease, and use of antibiotics were analyzed, the distribution and drug resistance of the pathogens cultured from the secretions of lower respiratory tract were observed, the statistical analysis was performed with the use of WHONET5 software, and the related risk factors for the hospital-acquired pneumonia were explored. RESULTS The hospital-acquired pneumonia occurred in 67 cases with the incidence rate of 0. 940/6. Totally＇ 79 strains of pathogens have been isolated, including 28 （35. 44%） strains of gram-positive bacteria and 51 （64. 56%） strains of gram-negative bacteria. The drug resistance rates of the Staphylococcus aureus to ampicillin, gentamicin, and sulfamethoxazole- trimethoprim were more than 60.00%; the drug resistance rates of the Pseudomonas aeruginosa to ampicillin and sulfamethoxazole-trimethoprim were more than 70.00% the drug resistance rates of the Acinetobacter to ampicillin, cefuroxime, cefatriaxone, and gentamicin were more than 65.00%. The incidence of the hospital-acquired pneumonia was related to the invasive operation, use of antibiotics, diabetes, age, and length of hospital stay. CONCLUSION The hospital-acquired pneumonia is related to multiple factors; it is necessary to take appropriate intervention measures according to the patients＇ real condition so as to reduce the incidence of hospital-acquired pneumonia.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第24期6128-6130,共3页
Chinese Journal of Nosocomiology
基金
浙江省杭州市科技发展基金资助项目(20110833B27)
关键词
医院获得性肺炎
病原菌
耐药性
危险因素
Hospital-acquired pneumonia
Pathogens Drug resistance
Risk factor
