高原地区医院内获得性肺部感染病原菌与药物敏感性调查

目的:明确高原地区医院内获得性肺部感染病原菌及其对抗菌药物的敏感性,为临床应用抗菌药物提供科学依据。方法:对我院2004~2006年1396例医院内获得性肺部感染住院患者的痰液与支气管冲洗液所进行的细菌学培养和药物敏感性试验报告及归档病历展开调查与分析。结果:培养出细菌789株,其中革兰阴性杆菌614株(占77·82%),以克雷伯菌属的分离率最高,为331株(占53·91%);革兰阳性菌166株(占21·04%),以葡萄球菌属的分离率最高,为78株(占46·99%)。大多数革兰阴性杆菌对亚胺培南、舒巴坦/头孢哌酮敏感,其次是氨基糖苷类;革兰阳性菌属对万古霉素的敏感率为90·36%。结论:医院内获得性肺部感染的病原菌以革兰阴性杆菌为主,对亚胺培南、舒巴坦/头孢哌酮敏感,对头孢他啶耐药率高,应引起临床重视。

Pathogenic Bacteria in Plateau Hospital-Acquired Pulmonary Infection and Antimicrobial Susceptibility

OBJECTIVE： To clarify the pathogens in plateau hospital- acquired pulmonary infection and their antimicrobial susceptibility so as to provide scientific basis for clinical first- line treatment in the rational use of antibacterial drugs. METHODS： The bacteriological culture and drug susceptibility experiment on sputum and bronchial douche fluid collected from 1 396 patients with hospital - acquired pulmonary infection in our hospital from 2004 to 2006 as well as the filed medical records were analyzed retrospectively. RESULTS： 789 positive bacteria were isolated, of which, 77.82% （614/789） were gram-negative bacilli （GNB）, with Klebsiella spp showing the highest percentage, accounting for 53.91% （331/614）; 21.04% （166/789） were gram-positive bacteria, with staph showing the highest percentage, accounting for 46.99% （78/789） .Most of the GNB were sensitive to imipenem, sulbactam/cefoperazone, then to aminoglycosides. The susceptibility rate of Gram-positive bacteria to vancomycin was 90.36%. CONCLUSION： Gram-negative bacilli were the main hospital infection pathogens, which were sensitive to imipenem, sulbactam/cefoperazone but highly resistant to ceftazidime, which calls for attention in the clinic.