干部科老年患者感染病原菌及耐药性分析

Antibiotic Resistance of Pathogens Isolated from Aged People in Medical Department for Senior Cadres′

目的监测老年患者感染病原菌及耐药情况,为临床用药提供参考。方法对2006年1月-2007年12月,老年患者临床标本病原学培养及药敏结果进行回顾性分析。结果病原菌1230株中,革兰阴性杆菌747株,占总分离率60.7%,大肠埃希菌、肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)为48.0%和35.8%;革兰阳性球菌310株,占25.2%,其中耐甲氧西林金黄色葡萄球菌(MRSA)65.0%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)77.8%,耐万古霉素肠球菌(VRE)17.7%,检测中未发现耐万古霉素葡萄球菌;真菌173株,占14.1%,主要为白色假丝酵母菌;病原菌对抗菌药物的耐药率较高,革兰阴性杆菌对氨苄西林、氨曲南、头孢菌素等敏感性较低,对亚胺培南、美罗培南、酶抑制剂复合制剂和阿米卡星的敏感性较高;革兰阳性球菌对万古霉素、替考拉宁敏感性高。结论老年患者感染病原菌以革兰阴性杆菌为主,病原菌耐药性较强,加强细菌药敏试验监测,可提供治疗老年感染的依据,做到合理选用抗菌药物。

OBJECTIVE To monitor the bacterial distribution and the drug resistance among elderly patients in Medical depariment for senior cadres＇ of our hospital, and offer the reference for the clinical use of antibiotics therapy. METHODS From Jan 2006 to Dec 2007 1230 pathogen strains isolated from the elderly patients and antimicrobial susceptibility was tested. RESULTS Of 1230 pathogen strains isolated, 747 strains were Gram- negative bacilli, 310 strains were Gram-positive cocci, and 173 strains were fungi. The percentage of these three groups were 60.7%, 25.2% and 14.1%, respectively. The major strain of fungi was Candida albicans. ESBLs producing rates of Escherichia coli and Klebsiella pneumoniae were 48.0% and 35.8%, respectively, Meticillin- resistant strains of Staphylococcus aureus （MRSA） and coagulase negative Staphylococcus （MRCNS） accounted for 65.0% and 77.8%, respectively. VRE were 17.7%. In our data, no vancomycin-resistant Staphlococcus was isolated. Pathogenic bacteria were higher resistant to the commonly used antibiotics. The Gram-negative bacteria were sensitive to imipenem, meropenem, antibiotics combined with β-lactamases inhibitor, and amikacin. The Gram-positive bacteria were sensitive to vancomycin and teicoplanin. CONCLUSIONS The major pathogens infected the elderly patients in Medical department for senior cadres＇ are Gram-negative bacteria, and the pathogens show the high drug resistance. The result of antimicrobial susceptibility test can guide to cure and control infection of elderly patients effectively.