老年人医院获得性肺炎病原菌的调查及耐药分析

Characteristics and Drug Resistance of the Pathogens of Hospital Acquired Pneumonia in Senile Patients

目的了解老年人医院获得性肺炎(HAP)的病原菌及耐药情况。方法对240例老年HAP患者的痰培养及药敏结果进行分析。结果痰标本中分离出168株细菌,主要为革兰阴性菌(60.7%)。其中铜绿假单胞菌占19.1%,克雷白菌属占15.5%,大肠埃希菌占11.3%,其它革兰阴性菌占14.8%。革兰阳性菌(34.5%),主要为金葡球菌(7.7%)和表葡球菌(8.9%)。致病菌为真菌的8例,约占4.8%。药敏分析,假单胞菌属、克雷白菌属、肠杆菌科细菌对氨苄西林的耐药率超过90%,对头孢唑啉的耐药率分别为96.5%、65%和100%。结论老年HAP患者的病原菌以革兰阴性菌为主,应根据药敏结果合理地选用抗生素。

Objective To study characteristics and drug resistance of the pathogens of hospital acquired pneumonia （HAP） in senile patients. Method Sputum cultures and drug sensitive tests of 240 cases of HAP were analysis. Results Microbiological analysis showed that gram-negative bacilli were dominant pathogens（60.7%） in senile HAP, in which 19.1% were Pseudomonas aeruginosa; 15.5% were klebsieUa; 11.3% were Escherichia coli; others account for 14.8%. Gram-positive bacilli accent for 34.5%, in which 7.7% were Staphylococcus aureus ; 8.9% were Staphylococcus epidermidis. Eight cases （4.8%） were fungi. Drug sensitive tests showed over 90% of pseudomonas, klebsieUa and enterobacteriaceae were resistant to ampicillin, while the resistant to cephazoline were 96.5%, 65%,and 100% respectively. Conclusions For senile patients with HAP,gram-negative bacillus was the dominant pathogen. Antibiotics should be correctly selected according to drug sensitive tests.