老年下呼吸道感染患者痰中细菌学分布及耐药性分析

Pathogens and their drug resistance in senile patients with lower respiratory tract infection

目的:研究老年下呼吸道感染患者痰中细菌学分布及耐药情况,指导临床用药。方法:采用常规痰细菌培养检出病原菌,用单纸片扩散法检测药敏,以双纸片法检测超广谱β-内酰胺酶(ESBLs)。结果:共分离出致病菌263株,其中,革兰氏阴性(G-)杆菌108株,占38.7%,肺炎克雷伯氏菌30株、大肠埃希氏菌26株、阴沟肠杆菌21株、不动杆菌17株;革兰氏阳性(G+)球菌64株,占24.3%,金黄色葡萄球菌28株、表皮葡萄球菌19株;真菌91株,占34.6%。在肺炎克雷伯菌和大肠埃希氏菌中,产ESBLs19株,总阳性率为33.9%。大多数G-杆菌对亚胺培南保持较高敏感性。结论:老年患者下呼吸道感染以G-杆菌为主。

Objective：To investigate the distribution of common pathogens of senile lower respiratory tract infection and drug resistance, to improve clinical therapeutic efficacy. Methods： The susceptibility to antimicrobial agents was tested with diffusion method on mueller-Hinton medium. The double-dish test for ESBLs Confirmed all putative ESBLs-producing strains. Results：A total of 263 strains were obtained from lower respiratory tract in senile patients. 108 of 263 strains were Gram-negative bacilli （38.7%）. There were 30 strains of Klebsiellae pneumonia,26 strains of Escherichia coli,21 strains of E. cloacae and 17 strains of Acinetobacter;64 strains of gram-positive bacteria（24.3%） and 91 strains of fungi（34.6%）. Nineteen strains（33.9%） produced ESBLs in Escherichia coli and Klebsiella pneumoniae. Most gram-negative bacilli kept high susceptibility to the imipenem. Conclusions： Grau-negative bacilli were predominant in aged patients with lower respiratory tract infection. Attention should be paid to multi-drug resistance of pathogenic bacteria and fungus infection.