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目的研究消化内科长期住院患者医院获得性肺部感染的病原菌分布与耐药性,为合理应用抗菌药物提供依据。方法回顾性分析2009年1月-2014年7月消化内科长期住院患者发生医院获得性肺部感染患者的病原菌分布及耐药性。结果监测417例患者中发生医院获得性肺部感染82例,发生率19.67%;检出病原菌91株,其中革兰阴性菌57株占62.64%,革兰阳性菌21株占23.08%,真菌13株占14.28%,主要革兰阴性菌包括铜绿假单胞菌、肺炎克雷伯菌、鲍氏不动杆菌和大肠埃希菌,其对亚胺培南敏感性较低,为18.75%~11.11%,而对氨苄西林/舒巴坦、头孢噻肟、哌拉西林/他唑巴坦、庆大霉素及环丙沙星的耐药性均较高88.89%~25.00%,主要革兰阳性菌有金黄色葡萄球菌、表皮葡萄球菌和肺炎链球菌,其对青霉素G耐药率100.00%,未发现对万古霉素耐药菌株;白色假丝酵母菌对抗真菌药物仍多为敏感。结论消化内科长期住院患者的医院获得性肺炎病原菌以革兰阴性菌为主,存在耐药性较高的状况,应根据药敏试验合理选择抗菌药物。
Objective To study the distribution and drug resistance of pathogenic bacteria in hospital-acquired pulmonary infection in long-term inpatients with gastroenterology and provide a basis for rational use of antimicrobial agents. Methods The distribution and drug resistance of pathogenic bacteria in hospital-acquired pulmonary infection in long-term inpatients with gastroenterology from January 2009 to July 2014 were retrospectively analyzed. Results Of the 417 hospitalized patients, 82 cases of nosocomial pulmonary infection were detected, the incidence rate was 19.67%. 91 pathogens were detected, of which 57 strains were Gram-negative bacteria, accounting for 62.64%, 21 strains were Gram-positive bacteria, accounting for 23.08% Strain accounted for 14.28%, the main Gram-negative bacteria, including Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii and Escherichia coli, its sensitivity to imipenem was 18.75% ~ 11.11 %, While the drug resistance to ampicillin / sulbactam, cefotaxime, piperacillin / tazobactam, gentamicin and ciprofloxacin were 88.89% ~ 25.00%, the main Gram-positive Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus pneumoniae, its penicillin G resistance rate of 100.00%, was found no vancomycin-resistant strains; Candida albicans anti-fungal drugs are still more sensitive. Conclusions Long-term hospitalized patients with digestive medicine hospital-acquired pneumonia pathogens are Gram-negative bacteria, there is a high resistance status, should be based on susceptibility testing reasonable choice of antimicrobial agents.