唐山地区成人社区获得性肺炎住院患者细菌感染状况及影响因素分析

目的了解唐山地区成人社区获得性肺炎住院患者细菌感染状况及影响因素,为唐山地区成人社区获得性肺炎住院患者的经验性治疗提供相关参考。方法对2008年1月至2010年12月在河北联合大学附属医院呼吸内科住院的476例成人社区获得性肺炎患者行痰和（或）咽拭子培养,部分患者行血培养和胸腔积液培养。结果痰和（或）咽拭子、血、胸水培养细菌阳性患者140例（29.4%）,其中革兰阳性细菌感染患者为44例（9.2%）,革兰阴性细菌感染患者96例（20.2%）;共检出细菌150株,其中革兰阳性菌及阴性菌分别为44株（29.3%）、106株（70.7%）,最常见菌株依次为肺炎克雷伯杆菌35株（23.3%）、肺炎链球菌31株（20.7%）、铜绿假单胞菌23株（15.3%）。不同性别和不同季节各种病原体检出率差异均无统计学意义;不同年龄组革兰阳性菌检出率差异无统计学意义,但革兰阴性菌随着年龄的增长检出率呈增加趋势,〉70岁组肺炎克雷伯杆菌和其他细菌（如大肠埃希杆菌等）检出率明显高于≤30岁组（P〈0.05）,而不同年龄组铜绿假单胞菌检出率则差异无统计学意义（P〉0.05）。结论成人社区获得性肺炎住院患者常见细菌感染为革兰阴性菌,在经验性治疗中尤其是对高龄患者应以抗革兰阴性菌治疗为主。

Bacteria infection and influencing factors of hospitalized adult patients with community acquired pneumonia in Tangshang area

Objective To understand bacteria infection and its influencing factors of hospitalized adult patients with community acquired pneumonia in Tangshang area and provide reference for empirical therapy of community acquired pneumonia.Methods 476 hospitalized adult patients with community-acquired pneumonia who were treated in Department of Respiratory Medicine of the Affiliated Hospital of Hebei Union University during January 2008 to December 2010 had sputum / throat swab culture,some patients got blood cultur...