不同医疗机构医院获得性肺炎转归及病原构成的-第三军医大学学报.docVIP

不同医疗机构医院获得性肺炎转归及病原构成的回顾性分析 朱佑明1,2，王利亚*3，黄永红4，罗永艾2(400016重庆，重庆医科大学附属第一医院呼吸内科1；2400022重庆，重庆市第一人民医院；400054重庆，重庆市第一社会福利院福康医院3；400060重庆市第六人民医院4) [摘要] 目的 了解重庆地区医院获得性肺炎(hospital acquired pneumonia，HAP)治疗转归、病原学分布及其耐药性特点，为本地区治疗HAP提供资料和依据。方法 选取重庆市不同等级4家医疗机构在2009年1月~2010年12月符合HAP诊断标准的病例512例，对患者的性别、年龄、治疗转归，基础疾病、病原学及其耐药谱进行回顾性对照研究。结果 4家医疗机构的HAP患者性别不存在差异，平均年龄以重庆市第一福利院[(78.6±7.3)岁)。HAP总死亡率为22.6%。与本次住院直接相关的基础疾病分析显示脑卒中及其后遗症是导HAP最常见的原因(24.4%)，其次是呼吸衰竭(17.2%)，其它依次为心血管病(.3%)，肿瘤(7.7%)，手术后(%)，慢阻肺(6.9%)，尘肺(5.%)，糖尿病(.4%)，老年痴呆(%)，营养不良(%)。脑卒中及其后遗症是导HAP最常见的原因Zhu Youming1,2, Wang Liya3, Huang Yonghong4, Luo Yongai2(1 Department of Respiratory Medicine, the First Affiliated Hospital, Chongqing Medical University, Chongqing 400016；2 Chongqing First People,s Hospital, Chongqing 400022；3 Chongqing First Social Welfare Institutions，Fukang Hospital，Chongqing 400054；4 Chongqing Sixth People,s Hospital, Chongqing 400060，China) [Abstract] Objective To investigate the outcome and the etiological distribution and bacterial susceptibility of HAP in order to help treatment. Methods A total of 512 cases of HAP in Chongqing different medical service from January 2009 to December 2010 were reviewed retrospectively including sex, old, outcome, basic disease, etiological distribution and pathogenic drug-resistant profile. Results There were no significant differences in sex, but with statistical significances in age (p＜0.05). The total mortality of HAP was 22.6% in Chongqing. The Gram-negative pathogenic bacterium (73.2%) were commonly existed, the most common Pseudomonas aeruginosa accounted for (27.2%). The Gram-positive bacterium were 22.9%, Staphylococcus aureus accounted for (13.0%), and then all fungi (3.9%) were mixed infection. The main causes of HAP were followed by stroke and sequela(24.4%)，respiratory failure(17.2%)， angiocardiopathy(8.3%)， malignancy(7.7%)，postop(7.1%)， COPD(6.9%), silicosis (5.9%)，diabetes.4%)，dementia%)，dystrophy2.4%). The pathogenic profile of HAP in Social Welfare Institut