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目的探讨社区获得性肺炎病原学分布及病原菌的耐药性,为制定防治策略和措施提供科学依据。方法收集深圳市罗湖区人民医院2010年1月—2012年12月社区获得性肺炎患者126例,留取痰液进行细菌培养,应用常规方法分离鉴定细菌,并分析病原菌的耐药性,同时检测患者肺炎支原体、肺炎衣原体血清抗体。结果共有53例患者病原学阳性,病原体分布情况为:肺炎支原体(23例)、流感嗜血杆菌(15例)、肺炎克雷伯菌(6例)、肺炎链球菌(5例)、肺炎衣原体(3例)。肺炎链球菌对青霉素、三代头孢、大环内酯类抗生素敏感,对喹诺酮类、磺胺抗生素耐药;流感嗜血杆菌仅对三代头孢高度敏感,对青霉素、喹诺酮类、磺胺类、大环内酯类耐药。高年龄组和春季病原菌阳性率较高,单个病原体在不同季节间分布差异无统计学意义,在不同年龄组间分布差异无统计学意义。结论非典型病原体尤其是肺炎支原体感染在罗湖社区获得性肺炎中占据主要地位,流感嗜血杆菌是社区获得性肺炎主要致病菌。不同季节、不同年龄病原体分布无明显差异。
Objective To explore the etiological distribution of pathogenic bacteria and community-acquired pneumonia and to provide a scientific basis for the development of prevention and treatment strategies. Methods 126 patients with community-acquired pneumonia were collected from People’s Hospital of Luohu District, Shenzhen from January 2010 to December 2012. The sputum was collected for bacterial culture. The bacteria were isolated and identified by routine methods and the pathogenic bacteria were tested for drug resistance. Mycoplasma pneumoniae, Chlamydia pneumoniae serum antibodies. Results A total of 53 patients were etiologically positive with pathogen distribution of Mycoplasma pneumoniae (23 cases), Haemophilus influenzae (15 cases), Klebsiella pneumoniae (6 cases), Streptococcus pneumoniae (5 cases), Chlamydia pneumoniae (3 cases). Streptococcus pneumoniae penicillin, third generation cephalosporins, macrolide antibiotics sensitive to quinolones, sulfa antibiotics resistant; Haemophilus influenzae only third generation cephalosporins highly sensitive to penicillin, quinolones, sulfonamides, macrolides Class resistance. The positive rate of pathogen in high age group and spring was high. There was no significant difference in the distribution of single pathogen in different seasons. There was no significant difference in distribution among different age groups. Conclusions Atypical pathogens, especially Mycoplasma pneumoniae infection, predominate in community-acquired pneumonia in Lo Wu. Haemophilus influenzae is the major cause of community-acquired pneumonia. In different seasons, there was no significant difference in the distribution of pathogens at different ages.