神经内科重症监护病房医院获得性肺炎病原菌分布及耐药性分析(1)
摘 要：目的 探讨神经内科重症监护病房医院获得性肺炎的病原菌分布以及对抗生素的耐药性，为抗感染治疗提供参考。方法 2016年1月～2017年12月入住湖南省第二人民医院神经内科重症监护病房合并院内获得性肺炎的患者79例，采集痰标本进行细菌分离及培养，并对其进行相关药敏试验。结果 共分离出89株病原菌，其中革兰氏阴性菌占87.64%，革兰氏阳性菌10.11%，真菌2.25%。病原菌以鲍曼不动杆菌(24.72%)、肺炎克雷伯菌(19.10%)、铜绿假单胞菌(17.98%)，金黄色葡萄球菌为主(8.99%)为主；鲍曼不动杆菌对大部分抗菌药物耐药，铜绿假单胞菌对头孢哌酮舒巴坦和头孢他啶的耐药率较高，肺炎克雷伯菌耐药率低。金黄色葡萄球菌对青霉素耐药率高。结论 HAP致病菌以革兰氏阴性菌为主，其中鲍曼不动杆菌耐药严重，同时也应注意革兰氏阳性菌和真菌感染。
关键词：重症监护病房；医院获得性肺炎；病原菌；细菌耐药性
中图分类号：R446.5 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.11.038
, 百拇医药
文章编号：1006-1959(2018)11-0121-03
Distribution and Drug Resistance of Pathogenic Bacteria Isolated from Hospital Acquired Pneumonia in Neurology Intensive Care Unit
ZHOU Gao-ya，XIANG Guang-hong，TANG Jia-yu，LI Ping，LI Xiao-juan，YANG Song-lin
(Department of Neurology，Hunan Brain Hospital，Changsha 410007，Hunan，China)
Abstract：Objective To investigate the distribution of pathogenic bacteria and antibiotic resistance in hospital acquired pneumonia in neurology intensive care unit(ICU)，and to provide reference for anti-infection therapy.Methods From January 2016 to December 2017，79 patients were admitted to the Department of Neurology，intensive care unit of the second people's hospital of Hunan province and hospital acquired pneumonia.The sputum specimens were collected for bacterial isolation and culture，and related drug susceptibility tests were conducted.Results A total of 89 strains of pathogenic bacteria were isolated，of which Gram-negative bacteria accounted for 87.64%，Gram-positive bacteria 10.11%，Fungi 2.25%.The pathogenic bacteria were mainly Acinetobacter baumannii (24.72%)，Klebsiella pneumoniae(19.10%)，Pseudomonas aeruginosa(17.98%)，Staphylococcus aureus was predominant(8.99%)； Acinetobacter baumannii was resistant to most antibacterial agents；Pseudomonas aeruginosa was resistant to cefoperazone sulbactam and ceftazidime；The primary bacteria resistance rate is low.Staphylococcus aureus is highly resistant to penicillin.Conclusion Gram-negative bacteria are the main pathogenic bacteria of HAP，and Acinetobacter baumannii has serious drug resistance.At the same time， attention should be paid to Gram-positive bacteria and fungal infections.
, 百拇医药
Key words：Intensive care unit；Hospital acquired pneumonia；Pathogenic bacteria；Bacterial resistance
醫院获得性肺炎(hospital acquired pneumonia，HAP)是神经内科重症监护室(neurology intensive care unit，NICU)最常见的医院内感染[1]，其发生率为11.7%～30.9%，占医院感染的48.3%，其病死率可达10.4%～35.3%[2]，明显增加病死率及住院时间。了解其病原菌的分布以及对抗生素的耐药性，对其治疗有重要意义。本文对2016年6月～2017年12月NICU合并医院获得性肺炎患者的痰培养及药敏结果进行分析，为临床抗感染治疗提供参考。, http://www.100md.com(周高雅 向光红 唐佳宇 李萍 李小娟 杨松林)
关键词：重症监护病房；医院获得性肺炎；病原菌；细菌耐药性
中图分类号：R446.5 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.11.038
, 百拇医药
文章编号：1006-1959(2018)11-0121-03
Distribution and Drug Resistance of Pathogenic Bacteria Isolated from Hospital Acquired Pneumonia in Neurology Intensive Care Unit
ZHOU Gao-ya，XIANG Guang-hong，TANG Jia-yu，LI Ping，LI Xiao-juan，YANG Song-lin
(Department of Neurology，Hunan Brain Hospital，Changsha 410007，Hunan，China)
Abstract：Objective To investigate the distribution of pathogenic bacteria and antibiotic resistance in hospital acquired pneumonia in neurology intensive care unit(ICU)，and to provide reference for anti-infection therapy.Methods From January 2016 to December 2017，79 patients were admitted to the Department of Neurology，intensive care unit of the second people's hospital of Hunan province and hospital acquired pneumonia.The sputum specimens were collected for bacterial isolation and culture，and related drug susceptibility tests were conducted.Results A total of 89 strains of pathogenic bacteria were isolated，of which Gram-negative bacteria accounted for 87.64%，Gram-positive bacteria 10.11%，Fungi 2.25%.The pathogenic bacteria were mainly Acinetobacter baumannii (24.72%)，Klebsiella pneumoniae(19.10%)，Pseudomonas aeruginosa(17.98%)，Staphylococcus aureus was predominant(8.99%)； Acinetobacter baumannii was resistant to most antibacterial agents；Pseudomonas aeruginosa was resistant to cefoperazone sulbactam and ceftazidime；The primary bacteria resistance rate is low.Staphylococcus aureus is highly resistant to penicillin.Conclusion Gram-negative bacteria are the main pathogenic bacteria of HAP，and Acinetobacter baumannii has serious drug resistance.At the same time， attention should be paid to Gram-positive bacteria and fungal infections.
, 百拇医药
Key words：Intensive care unit；Hospital acquired pneumonia；Pathogenic bacteria；Bacterial resistance
醫院获得性肺炎(hospital acquired pneumonia，HAP)是神经内科重症监护室(neurology intensive care unit，NICU)最常见的医院内感染[1]，其发生率为11.7%～30.9%，占医院感染的48.3%，其病死率可达10.4%～35.3%[2]，明显增加病死率及住院时间。了解其病原菌的分布以及对抗生素的耐药性，对其治疗有重要意义。本文对2016年6月～2017年12月NICU合并医院获得性肺炎患者的痰培养及药敏结果进行分析，为临床抗感染治疗提供参考。, http://www.100md.com(周高雅 向光红 唐佳宇 李萍 李小娟 杨松林)