老年患者下呼吸道医院感染病原菌分布及体外耐药监测

Distribution and Drug Resistance of Nosocomial Infection Pathogens from Lower Respiratory Tract in Senile Patients

目的 探讨老年患者下呼吸道感染常见病原菌的分布及耐药状况 ,制定针对性预防与控制措施。方法 对 2 85例下呼吸道感染的老年患者痰及下呼吸道分泌物进行常规细菌培养 ,用琼脂扩散法进行体外药物敏感试验 ,并加以统计分析。结果 老年下呼吸道感染病例的病原菌以革兰阴性杆菌为主 ,占 86 3%,其中铜绿假单胞菌检出率占首位 ,达 2 6 0 %;革兰阳性球菌中检出耐甲氧西林金黄色葡萄球菌占金黄色葡萄球菌总数的4 1 7%;体外耐药监测表明 :革兰阴性杆菌除流感嗜血杆菌对常用抗菌药物保持较好的敏感性外 ,其余细菌均已产生了较高的耐药性。结论 临床微生物室必须做好老年患者下呼吸道感染病原菌的检测工作 ,及时指导临床医师合理用药。

OBJECTIVE To study the distribution and drug resistance of nosocomial infection pathogens from lower respiratory tract in senile patients and give draft preventive and control measures. METHODS The sputum and lower respiration secretion of 285 senile patients were cultured to detect pathogens which were confirmed by routine methods. Disk diffusion test adopted to analyze drug resistance. RESULTS Gram-negative organisms accounted for 86.3%(246/285) were the major pathogens detected in lower respiratory tract in senile patients. Among Gram-negative organisms, Pseudomonas aeruginosa was the top one (26.0%,74/285). Of Gram positive organisms, meticillin-resistant Staphylococcus aureus (MRSA) were 41.7% among all S.aureus. All Gram-negative bacteria except Haemophilus influenzae showed high antibiotic-resistance. CONCLUSIONS It is necessary for clinical microbiology department to detect pathogens of lower respiratory tract infection in senile patients to give reasonable advice for medicine usage in time.