社区老年人上呼吸道定植菌调查及药敏分析

Investigation of Flora Colonization in Upper Respiratory Tract of the Aged in Community and Analysis of Antibiotics Sensitivity

调查社区老年人上呼吸道的定植菌情况,能够了解引起社区老年人呼吸道感染的危险因素,分析主要定植菌的药敏结果,指导社区老年人呼吸道感染的经验治疗。取社区老年人咽喉部拭子进行细菌分离培养及鉴定,调查呼吸道定植菌情况,并对主要定植菌进行药敏试验,细菌鉴定应用法国生物梅里埃公司的细菌鉴定仪VITEK2和API系统,药敏试验采用K-B纸片琼脂扩散法,结果统计应用WHONET5.4软件。对706例社区老年人上呼吸道标本进行分离培养,有274份标本生长了致病菌或条件致病菌,其中248份标本有一种细菌生长,26份标本生长2种细菌,总体阳性率为38.8%。共分离9种细菌,居首位的细菌是肺炎克雷伯菌151株,占21.4%,其次为副流感嗜血杆菌74株,占10.5%,第3位的是β-溶血链球菌31株,占4.4%。75株肺炎克雷伯菌的药敏结果显示全部为敏感株,从药敏表型分析具有较高的同源性。老年人群上呼吸道定植菌以革兰阴性杆菌尤其以肺炎克雷伯杆菌为主,并对常用抗菌药物有高度敏感性,一旦发生定植菌感染应选择合适的抗菌药物并给予恰当的治疗方案,防止细菌产生耐药性。

Investigation of flora colonization in upper respiratory tract among the aged in community could understand the dangerous factors that caused the respiratory tract infection among the aged in the community, and analyze the results of drug sensitivity of main flora colonization may direct experience treatment on old people who suffer from respiratory tract infection in the community. 706 pharynx and larynx swab samples collected from the aged in the community were carried out bacterial isolation culture and identification with French made Bio-Meliere bacterial identifier VITEK2 and API system, and carried out drug sensitivity test of main bacteria with Kirby-Bauer method, and result statistics was analyzed with WHONET 5.4 software. Among them 274 samples had pathogenic bacteria or conditional pathogenic bacteria to grow, 248 samples had one bacterium to grow, and 26 samples had two bacterium to grow, the total positive rate was 38.8% . Altogether 9 bacteria were isolated and identified and the top one was Klebsiella pneumoniae （Kp） , 151 strains, and account for 21.4% , the second one was Haemophilus influenzae, 74 strains, 10.5% ; the third one was-hemolytic streptococci, 31 strains, 4.4% ; among the Kp strains 75 strains were all drug sensitive with high homology by phenotype. Upper respiratory flora colonized bacteria are mainly Gram-negative rod bacteria, especially Kp, and highly sensitive to common antibiotics, in case of infection of flora colonized bacteria choose a proper antibiotics and give suitable treatment programme to prevent the bacteria from producing drug-resistance.