摘要
目的对广州市第一人民医院医院获得性肺炎(HAP)进行耐药性检测,以期指导临床治疗。方法 2011年1月—2012年6月在本院发生医院获得性肺炎且找到致病菌的患者,对致病菌进行细菌鉴定,纸片扩散法检测其耐药性。结果普通病房绝大多数患者以铜绿假单胞菌、金黄色葡萄球菌感染为主,其次为大肠埃希菌和肺炎克雷伯菌;ICU则以铜绿假单胞菌、金黄色葡萄球菌、嗜麦芽窄食单胞菌为主,其次为洋葱伯克霍尔德菌和白色念珠菌。金黄色葡萄球菌耐药情况严重,ICU中MRSA占100%,高于普通病房(89.33%,P<0.05)。普通病房铜绿假单胞菌对头孢他啶和环丙沙星的耐药性与ICU差异无统计学意义,均在30%左右。普通病房大肠埃希菌和肺炎克雷伯菌高度耐药。大肠埃希菌的耐药性甚至高于肺炎克雷伯菌(P<0.05),对三代头孢菌素的耐药性为50%～76.2%。四代头孢菌素的耐药性亦达43.8%。结论广州地区医院获得性肺炎耐药严重,不同科室致病菌构成及耐药情况有所不同。必须采取措施遏制其耐药性增长。
Objective To detect antibiotic resistance of hospital-associated pneumonia （HAP） pathogenic bacterium, so as to instruct the clinic antibiotic treatment. Methods Patients who were diagnosed of HAP with confirmed pathogens from Jan 2011 to June 2012 in our hospital were put into study. Pathogens were identified, and then the antibiotic resistance was determined by Kirty -Baucer disk diffusion assay. Results Pathogens in general ward were mainly pseudomonas aeruginosa and staphylococcus aureus, then followed by Escherichia coli and klebsiella pneumoniae. Pathogens in ICU were mainly pseudomonas aeruginosa, staphylococcus aureus and stenotrophomonas mahophilia, then followed by Burkhol deriacepacia and Candida albi- cans. Staphylococcus aureus had a high drug resistance. MRSA accounted for a higher ratio of staphylococcus aureus in ICU （ 100% ）, than in general ward （89. 33%, P 〈0. 05） . Pseudomonas aeruginosa had the same high drug resistance to ceftazidime and ciprofloxacin in general ward, as in ICU, all around 30%. Escherichia coli and klebsiella pneumoniae had a high drug resistance in general ward. With resistance of 50% - 76. 2% to the third-cephalosporin and resistance of 43.8% to the fourthcephalosporin. Escherichia coli had a higher drug resistance than klebsiella pneumoniae （P 〈 0. 05） . Conclusion The situa- tion of antibiotic resistance of HAP pathogen in Guangzhou district is very serious. There are different pathogen distribution and antibiotic resistance in different ward. Measures should be taken to control its antibiotic resistance.
出处
《广州医药》
2013年第2期47-49,56,共4页
Guangzhou Medical Journal
关键词
医院获得性肺炎
耐药性
病原菌
检测
Hospital-associated pneumonia
Antibiotic resistance
Pathogenic bacterium
Detection
