【摘要】 目的:探讨医院获得性肺炎(HAP)的临床特点、病原学分布和药敏情况,以指导临床诊疗。方法:回顾性分析2008年1月-2012年12月收治的76例HAP患者的临床资料。结果:HAP的发生率为1.69%,所有患者均有相关基础疾病和易患高危因素,合并两种以上基础疾病者死亡率高。分离的病原菌中,革兰氏阴性菌占60.17%,革兰氏阳性菌占32.20%,真菌占6.78%,不动杆菌、铜绿假单胞菌、肺炎克雷白杆菌、金黄色葡萄球菌为主要致病菌。不动杆菌、产ESBLs的肺炎克雷白杆菌耐药率较高,但碳青霉烯类和β-内酰胺类抗生素/酶抑制剂治疗效果仍较好,所有革兰氏阳性菌对万古霉素和利奈唑胺敏感。结论:减少各种高危因素,严格进行病原学检测和药敏试验,针对病原菌情况合理应用抗生素是提高HAP疗效的关键。更多还原

【Abstract】 Objective:To study the clinical characteristics,distribution and drug susceptibility of hospital-acquired pneumonia(HAP) to guide clinical diagnosis and treatment.Methods:The clinical data of 76 patients with HAP were analyzed retrospectively from Jan 2008 to Dec 2012.Results:The incidence rate of HAP was 1.69%.Relevant underlying diseases and high risk factors had been found in all the cases.The patients with two underlying diseases had a higher mortality rate.Of all isolated pathogens,gram-negative bacilli,gram-positive bacilli,fungal accounted for 60.17%,32.20%,6.78%,respectively.The most common pathogens of HAP were Acinetobacter,Pseudomonas aeruginosa,Klebsiella pneumoniae and staphylococcus aureus.Acinetobacter and ESBL-producing klebsiella pneumonia had higher drug resistant rates,however,were still sensitive to Carbapenem and β-lactam anticiotics/inhibiter of β-lactamases.Gram-positive bacteria were all susceptible to vancomycin and linezolid.Conclusions:Reducing the risk factors and performing pathogenic examination and drug sensitive test stiicdy is the key to improve the curative effect for HAP.更多还原