78例肺脓肿致病菌及耐药性分析

目的:探讨引起肺脓肿的病原菌的分布及耐药情况,指导临床合理应用抗生素。方法:回顾分析我院1999年1月至2005年8月收治的78例肺脓肿的感染致病菌。结果:43例伴基础疾病的肺脓肿以革兰阴性杆菌感染为主,无基础疾病的以革兰阳性球菌居多,两者比较差异有显著性;革兰阴性菌中常见致病菌为肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌和不动杆菌,对常用抗生素的敏感性为:亚胺培南92.3%,哌拉西林-三唑巴坦85.1%,头孢哌酮-舒巴坦77.7%,阿米卡星76.7%,头孢吡肟57.1%,环丙沙星52.8%。结论:在肺脓肿的起始经验性治疗时,伴有基础疾病的应首选抗革兰阴性杆菌的敏感药物,头孢吡肟、环丙沙星已严重耐药。

Pathogenic Species and Drug Resistance:Analysis of 78 Cases of Lung Abscess

Objective To investigate the pathogenic species and drug resistance in patients with lung abscess and its therapeutic stratedy.Methods To retrospectively analyze results ofculture of sputum and drug sensitivity test from 78 caces of lung abscess from 1999 Jan to 2005 Aug.Results Gram negative baceria was major pathogen in patients of lung abscess with basic diseases,on the contrary Gram positive bacteria was major pathogen in patients of lung abscess without basic diseases.Among Gram negative bacteria,the major sputum was Klebsiellapneumoniae,Pseudomonas aeruginosa,Escherichia coli and Acinetobacter.The sensitivity of drug from hightolow was asfollows:Imipenem(92.3%),Piperacillin-tazobactam(85.1%),Cefoperazone-sulbactam(77.7%),Amikacin(76.7%),Cefepime(57.1%) and Ciprofloxacin(52.8%).Conclusion Major cause of lung abscess with basic diseases may be Gram negative bacteria which have multidrug-resitance to Cefepime and Ciprofloxacin.