【摘要】 目的 了解近10年无肺部基础疾病患者社区获得性肺炎(CAP)病原菌及药物敏感性的变化，指导临床合理用药。方法 回顾性分析近10年272例在我院住院的CAP患者(排除肺部基础疾病者)痰病原菌培养及药物敏感性试验结果。结果 痰培养有病原菌生长者35例，检出病原菌17种,共321株。其中革兰阳性菌92株，占细菌总数28.7%，以葡萄球菌和肺炎球菌常见,对万古霉素敏感；革兰阴性菌201株，占62.6%，以肺炎克雷伯杆菌、铜绿假单胞菌、鲍曼不动杆菌和产气肠杆菌最多,其次为大肠埃希菌、副流感嗜血杆菌、普通变形杆菌等，主要对氨基糖苷类、三代头孢、喹诺酮类抗生素和泰能敏感；真菌28株，占8.7%。青中年人群CAP革兰阴性菌感染有明显上升趋势，老年人群CAP仍以革兰阳性菌多见。结论 无肺部基础疾病患者CAP的病原菌主要为革兰阳性菌和革兰阴性菌,革兰阴性菌感染有明显上升趋势，其主要对氨基糖苷类、三代头孢、喹诺酮类抗生素和泰能敏感性较高。

    【关键词】 社区获得性肺炎；病原菌；痰培养；药物敏感性试验

    Dieversify of pathogenic bacterium and drug sensitivity of patients with community aquired pneumonia and without lung diseases

    GUAN Yu-hong,TU Ling,XIONG Sheng-dao,et al.

    Tongji Hospital,Wuhan 430030,China

    【Abstract】 Objective To explore the diversify of pathogenic bacterium and drug sensitivity of patients with community aquired pneumonia (CAP) and without other lung diseases.Methods To explore retrospectively the diversify of pathogenic bacterium and drug sensitivity of 272 patients with CAP and without other lung diseases who had been in our hospital in recent 10 years.Results 35 patients’ sptum were cultured with pathogenic bacterium with 17 different kinds,total 321,in which there were 92 gram-positive(G+) bacterium(28.7%),201 gram-negative(G-) bacterium(62.6%) and 28 fungus(8.7%). G+ bacterium mainly included staphylococci and pneumococcus, G- bacterium mainly included Klebsiella pneumoniae, Pseudomonas aeruginosa, Bowman immovability bacillus and Enterobacter aerogenes.Those mid-younth with CAP had ascendance of G- bacterium,while the pathogenic bacterium of the old were mainly G+ bacterium.Conclusion The pathogenic bacterium of patients with CAP and without other lung diseases were mainly G+ bacterium and G- bacterium,the latter had a tendency of ascendance,which were sensitive to aminoglycosides,3rd cephalosporosides, quinolones and tienam. ......