铜陵地区社区获得性下呼吸道感染病原学分析
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摘要
目的分析铜陵地区社区获得性下呼吸道感染(LRTI)住院患者病原学分布特点;测定主要病原菌对常用药物的敏感性。方法纳入366例2016年8月—2017年12月铜陵市人民医院诊断为社区获得性LRTI(下呼吸道感染)的住院患者,收集其痰液及临床信息,用传统培养法、血清学方法检测病原体。结果 366例患者中,检测到病原体74株,主要为铜绿假单胞菌、肺炎支原体和肺炎克雷伯杆菌。5例患者(1.37%)存在2种以上病原体混合感染,其中肺炎支原体混合感染最为常见。25株铜绿假单胞菌对丁胺卡那、庆大霉素敏感率最高,均为100.00%,耐药率最高为头孢曲松,为33.00%。结论该地区社区获得性LRTI住院患者细菌检出率最高的为铜绿假单胞菌和肺炎克雷伯杆菌,非典型病原体为肺炎支原体。
Objective To analyze the etiological distribution features of community-acquired lower respiratory tract infection in Tongling region and measure the sensitivity of major pathological bacteria to the common drugs. Methods 366 cases of inpatients with community-acquired lower respiratory tract infection from August 2016 to December 2017 were selected,and the sputum and clinical information were collected, and the pathology was tested by the traditional culture method and serum method. Results Of 366 cases of patients, 74 strains of pathological bacteria were tested, mainly including pseudomonas aeruginosa, mycoplasma pneumoniae and klebsiella pneumonia, and 5 cases of patients 1.37% had the mixed infection of pathological bacteria more than two kinds, and the mycoplasma pneumonia mixed infection was the common, and the sensitivity rate of 25 strains of pseudomonas aeruginosa to amikacin, gentamicin was the highest 100.00%, and ceftriaxone had the highest drug-resistance rate 33.00%. Conclusion The test rates of pseudomonas aeruginosa and klebsiella pneumonia of inpatients with community-acquired lower respiratory tract infection are highest, and the atypical pathogen is the mycoplasma pneumonia.
Objective To analyze the etiological distribution features of community-acquired lower respiratory tract infection in Tongling region and measure the sensitivity of major pathological bacteria to the common drugs. Methods 366 cases of inpatients with community-acquired lower respiratory tract infection from August 2016 to December 2017 were selected,and the sputum and clinical information were collected, and the pathology was tested by the traditional culture method and serum method. Results Of 366 cases of patients, 74 strains of pathological bacteria were tested, mainly including pseudomonas aeruginosa, mycoplasma pneumoniae and klebsiella pneumonia, and 5 cases of patients 1.37% had the mixed infection of pathological bacteria more than two kinds, and the mycoplasma pneumonia mixed infection was the common, and the sensitivity rate of 25 strains of pseudomonas aeruginosa to amikacin, gentamicin was the highest 100.00%, and ceftriaxone had the highest drug-resistance rate 33.00%. Conclusion The test rates of pseudomonas aeruginosa and klebsiella pneumonia of inpatients with community-acquired lower respiratory tract infection are highest, and the atypical pathogen is the mycoplasma pneumonia.
引文
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[5]周庆涛,姚婉贞,陈亚红,等.慢性呼吸道疾病并发社区获得性下呼吸道感染住院患者的病原菌调查[J].中国呼吸与危重监护杂志,2007(2):82-87.
[6]亢瑞娜,刘晓霞,李君蕊.成人社区获得性下呼吸道感染患者的病原菌检测及耐药性分析[J].中华医院感染学杂志,2013,23(1):208-209,212.
[7]刘又宁,赵铁梅.下呼吸道感染病原体组成、耐药现状及对策[J].国外医学呼吸系统分册,2003(23):281-283.
[8]苏欣,施毅,宋勇.社区获得性肺炎病原体流行病学、耐药性及诊断研究进展[J].中国呼吸与危重监护杂志,2005(4):321-326.
[9]EI Sayed Zaki M,Goda T.Clinico-pathological study of atypical pathogens in community-acquired pneumonia:a prospective study[J].Infect Dev Ctries,2009(3):199-205.
[10]Masia M,Cutierrez F,Padilla S,et al.Clinical characterization if pneumonia caused by atypical parhogens combining classic and novel predictors[J].Clin Microbiol Infect,2007(13):153-161.
[11]Sohn JW,Park SC,Choi YH,et al.Atypical pathogens as etiologic agents in hospitalized patients with community-acquired pneumonia in Korea:a prospective multi-center study[J].J Korean Med Sci,2006(21):602-607.
[12]Lui G,Ip M,Lee N,et al.Role of‘atypical pathogens’among adult hospitalized patiens with community-acquired pneumonia[J].Respirology,2009(14):1098-1105.
[13]Tao LL,Hu BJ,He LX,et al.Etiology and antimicrobial resistance of community-acquired pneumonia in adult patients in China[J].Chin Med J(Engl),2012,125:2967-2972.
[2]周心怡,黄晖蓉,万毅新.下呼吸道病原菌分布与耐药性分析[J].临床肺科杂志,2013,18(10):1777-1778.
[3]李维香,曹洁.基层医院下呼吸道感染病原学及耐药分析[D].天津:天津医科大学研究生院,2013.
[4]陈愉生,林晓红,李鸿茹.下呼吸道感染住院患者病原学分析及判别模型的建立[J].中华结核和呼吸杂志,2017,40(12):909-914.
[5]周庆涛,姚婉贞,陈亚红,等.慢性呼吸道疾病并发社区获得性下呼吸道感染住院患者的病原菌调查[J].中国呼吸与危重监护杂志,2007(2):82-87.
[6]亢瑞娜,刘晓霞,李君蕊.成人社区获得性下呼吸道感染患者的病原菌检测及耐药性分析[J].中华医院感染学杂志,2013,23(1):208-209,212.
[7]刘又宁,赵铁梅.下呼吸道感染病原体组成、耐药现状及对策[J].国外医学呼吸系统分册,2003(23):281-283.
[8]苏欣,施毅,宋勇.社区获得性肺炎病原体流行病学、耐药性及诊断研究进展[J].中国呼吸与危重监护杂志,2005(4):321-326.
[9]EI Sayed Zaki M,Goda T.Clinico-pathological study of atypical pathogens in community-acquired pneumonia:a prospective study[J].Infect Dev Ctries,2009(3):199-205.
[10]Masia M,Cutierrez F,Padilla S,et al.Clinical characterization if pneumonia caused by atypical parhogens combining classic and novel predictors[J].Clin Microbiol Infect,2007(13):153-161.
[11]Sohn JW,Park SC,Choi YH,et al.Atypical pathogens as etiologic agents in hospitalized patients with community-acquired pneumonia in Korea:a prospective multi-center study[J].J Korean Med Sci,2006(21):602-607.
[12]Lui G,Ip M,Lee N,et al.Role of‘atypical pathogens’among adult hospitalized patiens with community-acquired pneumonia[J].Respirology,2009(14):1098-1105.
[13]Tao LL,Hu BJ,He LX,et al.Etiology and antimicrobial resistance of community-acquired pneumonia in adult patients in China[J].Chin Med J(Engl),2012,125:2967-2972.