摘要
目的探讨医院内肺部肠球菌感染的临床特征和影响预后的因素。方法应用回顾性调查的方法对68例医院内肺部局球菌感染患者进行分析。结果68例院内肺部肠球菌感染均患有基础疾病，其中以肿瘤性疾病、慢性阻塞性肺疾病（COPD）、重型肝炎和慢性肾脏病多见。感染以粪肠球菌为多（79％），屎肠球菌为18％。肠球菌对临床常用的抗生素的耐药率高，对庆大霉素、阿米卡星、氧氟沙星、环丙沙星的耐药率在54％～82％，对青霉素、氨■西林、氨■西林／舒巴坦的耐药率在22％～29．4％，对亚氨培南的耐药率17．6％。肠球菌对万古霉素的耐药率为5．9％，屎肠球菌的耐药率明显高于粪肠球菌。68例肠球菌肺感染，48例（7％）为混合感染．48例混合感染的病原体，依次是真菌、MRSA、不动杆菌、铜绿假单胞菌、嗜麦芽寡养单胞菌、MRSCON、阴沟肠杆菌、肺炎克雷伯氏菌等。68例肺部肠球菌感染患者，病死率44％（30／68）。有肿瘤性疾病、重型肝脏疾病、慢性肾脏疾病和COPD的患者病死率高。感染的肠球菌对万古霉素耐药的患者病死率最高。48例混合感染，病死率52％（25／48）明显高于单纯肠球菌感染25％（5／20）的病死率（x2＝4．200，P＜0．05）。结论 医院内肠球菌肺感染发病呈上升趋势，病死率高，致死因素较多，与基础疾病。
ABSTRACT:Objective: To investigate the clinical features of nosocomial enterococcal pulmonary infection(NEPI) and the major factors influencing prognosis of NEPI. Method: 68 cases with NEPI were retrospectivelyanalyzed. Results: Various predisposing diseases were found in total cases. Among them, tumourous diseace, chronicobstructive pulmonary disease (COPD), serious hepatitis and chronic renal disease were the most prevalent.Enterococcus faecalis was ranked the first pathogen (79% ) and E. faecium was the second one (18% ). In 68enterococcal strains, rate of resistance to vancomycin was 5. 9% but highly resistant to other antibacterial agents.Different species of enterococci had different resistance to drugs and the rate of resistance against E.faecium was muchhigher than that of E. faecalis. Complex infection rate of 68 cases were 71 % (48/68 ). The mortality of NEPI was 44%.Tumourous disease, serious hepatic disease, chronic renal disease and COPD showed high mortality. Mortality case ofthe patients infected by vancomycin-resistant enterococci was the highest; and followed by those affected by complexinfections (x2 = 4.200,P < 0. 05 ). Conclusion: The mobidity of NEPI is rising and the mortality is very high,especially due to predisoped diseases like, multidrug-resistant enterococcal infections, especially vancomycin-resistantenterococcal infections and complex infections. Clinicians should pay mone attention to it.
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2002年第4期233-236,共4页
Chinese Journal of Antibiotics
关键词
肺部肠球菌
院内感染
临床分析
KEYWORDS:Enterococci
Lung
Nosocomial infection
Clinical analysis
