Zhang Yanan, Shou Songtao
Beijing Tongren Hospital Beijing, China.
Deputy Director of ED of Tianjin Medical University General Hospital Tianjin, China.
Int J Biochem Mol Biol. 2021 Apr 15;12(2):49-54. eCollection 2021.
Observing the pathogens and drug-resistance within hospital-acquired pneumonia (HAP) in an emergency intensive care unit (EICU) to provide a reference for clinically reasonable use of antibiotics.
Sixty-two patients with HAP in Tianjin Medical University General Hospital from January 2017 to May 2019 were analyzed retrospectively. Bacterial identification and susceptibility were reviewed.
One hundred and thirty-seven strains of pathogenic bacteria were isolated from 62 patients, with 97.1% Gram-negative and only 2.9% Gram-positive. There were also six fungal isolates. The most common pathogens were Acinetobacter baumannii, accounting for 30.8% of all isolates, followed by Klebisella spp, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, and Escherichia coli. Acinetobacter baumannii was poorly susceptible to piperacillin-tazobactam, cefepime, Amoxicillin+clavulonic acid, ciprofloxacin. However, the isolates were sensitive to Tigecycline, so as the isolates of Klebisella spp. Pseudomonas aeruginosa was mostly sensitive to Amikacin, followed by Tobramycin. All of the isolates of Staphylococcus aureus were susceptible to Linezolid, Tigecycline and Vancomycin.
Gram-negative bacteria especially Acinetobacter baumannii, are the main pathogens for HAP in the observed EICU. The variety of pathogens should be monitored at regular intervals to improve resistance issues and therapeutic effect.
观察急诊重症监护病房（EICU）医院获得性肺炎（HAP）的病原菌及耐药情况，为临床合理使用抗生素提供参考。
回顾性分析2017年1月至2019年5月天津医科大学总医院62例HAP患者。对细菌鉴定及药敏结果进行分析。
62例患者共分离出137株病原菌，革兰阴性菌占97.1%，革兰阳性菌仅占2.9%，还有6株真菌。最常见的病原菌是鲍曼不动杆菌，占所有分离株的30.8%，其次是克雷伯菌属、铜绿假单胞菌、嗜麦芽窄食单胞菌和大肠埃希菌。鲍曼不动杆菌对哌拉西林-他唑巴坦、头孢吡肟、阿莫西林+克拉维酸、环丙沙星耐药性差。然而，其分离株对替加环素敏感，克雷伯菌属分离株也如此。铜绿假单胞菌大多对阿米卡星敏感，其次是妥布霉素。金黄色葡萄球菌所有分离株对利奈唑胺、替加环素和万古霉素敏感。
革兰阴性菌尤其是鲍曼不动杆菌，是所观察EICU中HAP的主要病原菌。应定期监测病原菌种类，以改善耐药问题及治疗效果。
