老年患者下呼吸道感染病原菌分布与耐药性分析

Pathogenic Bacteria of Lower Respiratory Tract Infection in Elderly Patients:Analysis of Distribution and Drug Resistance

目的了解老年患者下呼吸道感染常见病原菌分布和耐药状况。方法对1739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K-B法进行药敏分析。结果老年下呼吸道感染患者的病原菌以革兰阴性杆菌为主,占63.8%,主要有大肠埃希菌、铜绿假单胞菌、鲍氏不动杆菌、阴沟肠杆菌、肺炎克雷伯菌;革兰阳性球菌占22.9%,主要有金黄色葡萄球菌、凝固酶阴性葡萄球菌、肺炎链球菌和肠球菌属;同时还检出酵母样真菌232株;药敏结果显示,革兰阴性杆菌对亚胺培南、头孢哌酮/舒巴坦、阿米卡星较为敏感,革兰阳性球菌对万古霉素均敏感。结论临床微生物室必须及时准确地检测老年患者下呼吸道感染病原菌,以指导临床医生合理应用抗菌药物。

OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria from lower respiratory tract infection in elderly patients. METHODS A total of 1739 strains of bacteria isolated from sputum and lower respiration secretion culture of the elderly patients were identified and their drug resistance was tested by K-B method. RESULTS From 1739 strains of pathogens isolated, Gram-negative bacilli accounted for 63.8%. The main Gram-negative bacilli were Escherichia coli and Pseudomonas aeruginosa, Acinetobacter baumannii, Enterobacter cloacae and Klebsiella pneumoniae. Gram-positive cocci accounted for 22.9 % and Candida albicans accounted for 13. 3%, respectively. The resistance rates of Gram-negative bailli to imipenem, cefoperazone/ sulbactam and amikacine were relatively low. And all Gram-positive cocci were sensitive to vancomycin. CONCLUSIONS The antimicrobial resistance of pathogens in elderly patients with lower respiratory tract infection is serious. It is important to mornitor the antimicrobial resistance.