【摘要】 目的 探讨肺炎导致严重脓毒症患者的临床特点、病原学构成和耐药特点。方法 对110例脓毒症合并肺炎患者的一般资料、临床表现、基础疾病及病原检测结果及耐药情况进行分析。结果 110例合并脓毒症肺炎患者中分离出病原菌88株,其中肺炎克雷伯菌30例(34.1%),铜绿假单胞菌25例(28.4%),大肠埃希菌14例(15.9%);在合并严重脓毒症肺炎患者中,肺炎克雷伯菌是最常见的革兰阴性菌,而金黄色葡萄球菌是最常见的革兰阳性菌。合并严重脓毒症肺炎组病原菌对头孢他定、头孢曲松及头孢噻肟钠的耐药率分别是11.53%(6/52)、11.53%(6/52)、9.61%(5/52);而合并非严重脓毒症肺炎组病原菌的耐药率则是31.01%(18/58)、37.93%(17/58)、29.31%(22/58)。两组间差异具有统计学意义(χ~2值分别为5.390、10.065、5.035;P值均<0.05)。结论 革兰阴性杆菌是严重脓毒症肺炎患者的主要病原菌,非严重脓毒症肺炎组病原菌耐药情况比严重脓毒症严重。更多还原

【Abstract】 Objective To analyze the clinical and etiological characteristics of sepsis induced by pneumonia and to evaluate antibiotic susceptibility of the pathogens.Methods A prospective study was conducted on sepsis patients induced by pneumonia in ICU of People’s Hospital of Guizhou Province.The sputum and blood samples were collected for culture and bacteria were isolated and identified using conventional methods and the antimicrobial susceptibility against bacteria by Kirby-Bauer method was tested.Results There were 110 patients with 88 strains of isolated pathogenic bacteria.The most common pathogen was Klebsiella pneumonia(34.1%,30/88),the second and the third were Pseudomonas aeruginosa(28.4%,25/88)and Escherichia coli(15.9%,14/88),respectively.In severe sepsis with pneumonia,Klebsiella pneumonia was the most isolated pathogens and Staphylococcus aureus was the major isolated gram positive coccus pathogen.The resistant rate of isolates from severe sepsis with pneumonia patients were 11.53%(6/52),11.53%(6/52),9.61%(5/52)to ceftazidime,cefotaxime sodium and ceftriaxone respectively,which were significantly higher than isolates from sepsis(P<0.05).Conclusion Gram negative bacteria plays an important role in severe sepsis induced by pneumonia,and the degree of drug resistance to antibiotics from sepsis are higher than those isolated from severe sepsis.更多还原