革兰阴性菌肺部感染病例回顾性分析

目的回顾性分析多重耐药（MDR）革兰阴性菌和非MDR革兰阴性菌肺部感染的差异，探讨MDR细菌对患者的影响，给临床医师选择用药提供参考。方法收集我院2012年1月至2012年12月合格呼吸道标本、血液、胸腔积液等临床标本中分离出的MDR革兰阴性菌和非MDR革兰阴性菌，根据临床资料将导致肺部感染的病例纳入研究，分析MDR组和非MDR组之间的差异。结果MDR革兰阴性菌和非MDR革兰阴性菌科室分布不同。MDR革兰阴性菌和非MDR革兰阴性菌在住院天数、血清白蛋白、日均住院费用、先期使用抗生素、先期使用碳青霉烯类抗生素、病死率之间的差异有统计学意义（P〈0．05），在年龄、血红蛋白、感染时间之间的差异无统计学意义（P〉0．05）。结论MDR革兰阴性菌感染是临床抗生素选择面临的挑战，增加患者病死率，增加住院费用，我们需要高度重视。

Retrospective analysis of lung infections caused by gram-negative bacteria

Objective To retrospectively investigate the differences of lung infection caused by multi-drug resistant （MDR） gram-negative bacteria and non-MDR gram-negative bacteria, to study theimpact of MDR bacteria in patients,and to provide reference for clinicians to choose treatment. Methods The MDR gram-negative bacteria and non-MDR gram-negative bacteria isolated from qualified respiratoryspecimens,blood, pleural effusion, and other clinical specimens in our hospital from January 2012 to December 2012 were collected. The cases were recruited when they were clinically diagnosed as lunginfection. The differences between MDR group and non-MDR group were analyzed. Results MDR gram- negative bacteria and non-MDR gram-negative bacteria distributed in different departments. There wasstatistical significance in hospital stays, serum albumin, the average daily cost of hospitalization, early use of antibiotics, early use of carbapenems, and mortality between MDR gram-negative bacteria and non-MDRgram-negative bacteria （ P 〈0.05）. There was no statistical significance in age, hemoglobin, duration of infection between two groups （ P 〉 0.05）. Conclusions MDR gram-negative bacterial infection is aclinical challenge in selection of antibiotic, it increases mortality and hospital costs, we need to pay close attention.