老年社区获得性肺炎和医院获得性肺炎痰培养结果分析

摘要

Objective To investigate the distribution of the pathogens of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) in elderly patients, and to provide guidance for clinical diagnosis and treatment. Methods Sputum culture was performed for 372 elderly patients with CAP or HAP in our hospital. The results were statistically analyzed. Results The positive rate of sputum culture was 29.5% for CAP and 48.15% for HAP. In the etiological bacterial species, Streptococcus pneumoniae (41.18%) and Haemophilus influenzae (32.35%) were the main pathogens for CAP, while Pseudomonas aeruginosa (25.53%), Klebsiella pneumoniae (15.96%), Staphylococcus aureus (14.89%), Fungus (10.64%), Escherichia coli (10.64%) were the main pathogens for HAP. Conclusion The composition of bacteria between the CAP and HAP showed significant difference. Reasonable application of antibiotics should be based on the symptoms, the results of sputum culture and the possible pathogen species. For HAP, it is necessary to strengthen the control of infection pathway, sputum culture and drug susceptibility testing, constitute the treatment plan according to the testing results, and attach great importance to get a complete course of early, combined antibiotic therapy.%目的 探讨老年社区获得性肺炎和医院获得性肺炎病原菌分布,为临床诊治提供依据.方法 对我院372例住院老年社区获得性和医院获得性肺炎患者进行痰培养,并对结果进行统计分析.结果 老年社区获得性肺炎和医院获得性肺炎痰培养阳性率分别为29.05％和48.15％；老年社区获得性肺炎病原菌主要以肺炎链球菌(41.18％)和流感嗜血杆菌(32.35％)为主,医院获得性肺炎(HAP)主要是铜绿假单胞菌(25.53％)、肺炎克雷伯菌(15.96％)、金黄色葡萄球菌(14.89％)、真菌(10.64％)、大肠埃希菌(10.64％).结论 老年社区获得性肺炎与医院获得性肺炎病原菌构成差异较大.对社区获得性肺炎治疗应根据患者症状、痰培养结果及可能的病原体选用合理的抗菌药物,对医院获得性肺炎应加强对患者感染途径的控制和痰标本培养和药敏监测,根据监测结果制定治疗方案,早期、联合、足疗程用药十分关键.