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目的:了解院内获得性肺炎的临床特点及病原菌分布,改善预后。方法:回顾性分析2004年1月-2009年12月收治的院内获得性肺炎60例的临床资料。结果:基础病是血液病18例(30%),脑血管病9例(15%):临床症状中发热占96.7%,咳嗽占63.3%;痰培养阳性率95.0%,铜绿假单胞菌和肺炎克雷伯氏菌为两个主要致病菌,药敏试验发现铜绿假单胞菌对第三代头孢菌素耐药性增加,肺炎克雷伯氏菌对多种抗生素产生耐药。铜绿假单胞菌感染病人死亡率为58.1%,肺炎克雷伯氏菌感染为48.4%,混合感染为67.7%。结论:院内获得性肺炎的病人基础病多,病原菌对抗生素耐药率高,治疗难度大,预后差。
Objective: To understand the clinical characteristics of nosocomial pneumonia and the distribution of pathogens to improve the prognosis. Methods: The clinical data of 60 patients with nosocomial pneumonia admitted from January 2004 to December 2009 were retrospectively analyzed. Results: The basic diseases were hematological diseases in 18 cases (30%) and cerebrovascular diseases in 9 cases (15%). The clinical symptoms were fever (96.7%), cough (63.3%), sputum culture positive rate was 95.0%, Pseudomonas aeruginosa Klebsiella pneumoniae is the two main pathogens, drug sensitivity test found that Pseudomonas aeruginosa increased resistance to the third generation cephalosporins, Klebsiella pneumoniae resistant to a variety of antibiotics. The mortality rate of patients infected with Pseudomonas aeruginosa was 58.1%, that of Klebsiella pneumoniae was 48.4%, and that of mixed infection was 67.7%. Conclusions: The patients with nosocomial pneumonia have more basic diseases, high rates of antibiotic resistance of pathogens, difficult treatment and poor prognosis.