肺部感染常见病原菌和感染正相关因素分析.docVIP

肺部感染常见病原菌和感染正相关因素分析 　　【摘要】 目的：了解肺部感染常见的病原菌，探讨其感染相关因素及致病菌构成比，为防治和治疗提供指导。方法：对诊断为肺部感染的316例患者进行痰菌培养及药敏试验，并对感染相关因素进行分析。结果：痰菌培养阳性率41.77%。病原菌中革兰氏阴性菌占49.24%；真菌40.91%；革兰氏阳性菌9.84%。与肺部感染关系密切的相关因素中，使用广谱抗生素94例，占71.21%；侵入性操作史者34例，占25.75%；腹部或胸部手术史者24例，占18.18%；使用激素和免疫抑制剂13例，占9.84%。结论：肺部感染的致病菌主要为革兰氏阴性菌，其次为真菌和革兰氏阳性菌。致病菌中占比例较高的主要有铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、白色念珠菌和金黄色葡萄球菌等。不合理使用广谱抗生素和免疫抑制剂；侵入性操作；原有基础疾病所引起的抵抗力下降；胸腹部手术等是引起或加重肺部感染的主要因素。 　　【关键词】 肺部感染； 病原菌； 构成比； 易感因素 　　Analysis of Positive-related Factors between Pathogenic bacteria and Infection in Pulmonary Infection Patients/ZHANG Jian-wei，SHAO Rui-fang，ZHAO Tian-hai.//Medical Innovation of China，2014，11（01）：023-024 　　【Abstract】 Objective：To explore the common pathogenic bacteria of lung infection， the infection related factors and percentage so as to provide direction of prevention and therapy.Method：The sputum samples of 316 patients with pulmonary infection were cultured and given drug sensitivity test， along with analyzing infection-related factors.Result：The positive proportion of sputum culture were 41.77%， including Gram-negative bacteria（49.24%）， fungi（40.91%） and gram-positive bacteria（9.84%）. In the factors of close-related with pulmonary infection， using broad-spectrum antibiotic were 94（71.21%）cases， invasive operation were 34（25.75%） cases， abdomen and thoracic surgical operation were 24（18.18%） cases， using glucocorticoid and immunosuppressants were 13（9.84%） cases.Conclusion：The main pathogenic bacteria of pulmonary infection are gram-negative bacteria， followed by fungi and gram-positive bacteria. The below are the high percentage of pathogenic bacteria， such as Pseudomonas aeruginosa， Klebsiella pneumonia， Escherichia coli， Candida albican， Staphylococcus aureus. Using broad-spectrum antibiotics unreasonably and using immunosuppressants， invasive operation， low immunity caused by underlying diseases， thoracic and abdominal surgical operation are main causes and factors for pulmonary infection patients. 　　【Key words】 Pulmon