老年患者呼吸道致病菌耐药性监测及治疗对策

Surveillance of Pathogenic Bacteria in the Respiratory Tracts and their Resistance to Antimicrobial Agents in Geriatric Patients

为了解老年患者呼吸道常见致病菌及其耐药性，本文采用１７种抗菌药纸片，Ｋ—Ｂ琼脂扩散法对１９９６年１～１２月武汉地区１３所大中型医院６０岁以上住院患者从痰中分离出６００株细菌进行耐药性监测，结果显示１２４株（２０６６％）为革兰阳性球菌，４７６株（７９３３％）为革兰阴性杆菌。金葡菌中４６９１％（３８／８１）耐苯唑西林，且呈多重耐药，对８０％抗菌素耐药。对亚胺配南、万古霉素均敏感。革兰阴性杆菌中检出绿脓杆菌１４９株（３１３０％）对亚胺配南、环丙沙星、头孢他啶、阿米卡星耐药率在１０％以下。检出克雷伯菌属１２２株（２５６３％），除对氨苄西林耐药率在８０％以上，余下１６种抗生素耐药率均在２０％以下。１７种抗菌药物对６００株革兰阳性球菌及革兰阴性杆菌抗菌活性最强者依次为亚胺配南、阿米卡星、环丙沙星。

To understand the distribution of the pathogenic bacteria of the respiratory tracts and their resistance to common antimicrobial agents in geriatric patients,all the pathogenic bacteria isolated from sputum in senile hospitalized patients in 13 large general hospitals in Wuhan were collected during 1996,and their resistance to 17 antimicrobial agents were assayed by K-B method.Six hundred strains of pathogens which consisted of Gram-positive cocci 124(2066%) and Gram-negative bacilli 476(79.33%)were obtained.46.91% of Staphylococcus aureus was MRSA and presented multiple resistance.However,no S.aureus was discovered resistant to IPM and VAN.In bacilli,a low resistant rate(<10%) of Pseudomanas aeroginosa (149 strains) to IPM.CIP.CAZ.AMK was detected;the resistant rate of Klebsiella sp.to 16 antimicrobial agents was below 20% but to AMP was higher than 80%.The susceptibility of 600 strains of bacteria to these agents was orderly IPM,AMK,CIP,CAZ.