摘要
目的了解呼吸病房非发酵革兰阴性杆菌所致院内获得性肺炎的危险因素及耐药性,为临床医生治疗感染性疾病抗菌素的选择提供依据。方法细菌鉴定采用常规方法,API系统补充鉴定,药敏试验采用纸片扩散法,对169例非发酵革兰氏阴性杆菌引起的院内获得性肺炎患者的危险因素及耐药性的临床资料进行了回顾性分析。结果非发酵革兰阴性杆菌分离率62%,其中铜绿假单胞菌35.8%,不动杆菌12.8%,嗜麦芽窄食单胞菌6.9%,洋葱假单胞菌6.4%。临床资料显示,高龄、有严重的基础疾病、免疫功能受损、机械通气、以及高效、广谱抗菌素的应用,是非发酵革兰阴性杆菌定植的危险因素。而药敏试验显示,该组细菌对头孢菌素耐药率极高,对加酶抑制剂复方制剂、亚胺培南、丁胺卡那、头孢他啶、环丙沙星耐药率较低。结论非发酵革兰阴性杆菌是院内获得性肺炎的主要致病菌群,其耐药率高、难治性强,因此,建立系统防范措施,合理应用抗生素,控制高危因素是降低其感染发生的重要因素。
Objective To learn the status quo of nosocomial pneumonia caused by non-fermentation Gram negative bacilli in the respiratory department of our hospital and give the clinical doctors some advises in choosing the antibiotics to cure the infective diseases.Methods We retrospective analyzed the clinical data of 169 patients, identified the bacilli with the routine method, API system and susceptibility tests in disk-diffuse method.Results The separating rate of non-fermentation Gram negative bacilli was 62% （35.8% of which was Plaeruginosa, 12.8% Acinetobacter Baumannii, 6.9% Stenotrophomas Maltophilia, 6.4% B.Cepacia）.Clinical materials demonstrated that ageing, critical undering disease, elongation of duration in ICU, immunological dysfunction, tracheal cannula or tracheotomy and broad-spectrum antibiotics useage for a long time were the primary risk factors related to the nosocomial infection by non-fermentation Gram negative bacilli.Susceptibility tests showed that these bacteria had high resistance to cephalosporin and relative low resistance to compound of β lactamase inhibitor, imipenem, amikacin, ceftazidime and ciprofloxacin.Conclusion Non-fermentation gram-negative bacilli were the major pathogens, they had high resistance rate and are difficult to control. To decrease the infection rate,we must prevent the infections systemically,use antibiotics reasonably and control high risk factors.
出处
《中国血液流变学杂志》
CAS
2007年第2期290-292,共3页
Chinese Journal of Hemorheology
关键词
非发酵革兰阴性杆菌
医院获得性肺炎
non-fermentation gram negative bacilli
nosocomial pneumonia
