老年患者下呼吸道感染病原菌谱及耐药性监测

Bacterial spectrum and resistance surveillance from lower respiratory tract infection in senile patients

目的探讨老年患者下呼吸道感染病原菌谱和耐药性,为临床治疗提供用药依据。方法 802例下呼吸道感染老年患者合格痰标本细菌学培养及鉴定,用K-B法测定病原菌耐药性。结果 802例合格痰标本中,分离出964株细菌和118株真菌,复数细菌感染162株,占20.2%;G^-菌占66.7%,铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、不动杆菌属和阴沟肠杆菌分列前5位;G^+菌占22.4%,金黄色葡萄球菌、肺炎链球菌及表皮葡萄球菌分列前3位;真菌占10.9%,以白色念珠菌为主;药敏结果提示,除真菌以外的大多数细菌出现多重耐药,革兰阴性菌对亚胺培南敏感,革兰阳性菌对万古霉素敏感。结论对老年患者下呼吸道感染病原菌进行耐药性监测,对临床合理用药具有重要的指导意义。

Objective To study the bacterial spectrum and drug resistance of lower respiratory tract infection in senile patients and provide useful information for the clinical treatment.Methods Qualified sputum specimens of 802 senile patients were cultured and identified and drug resistance was analyzed by K-B method.Results From 802 samples were isolated 964 strains of bacteria and 118 strains of fungi,there were 162 cases with multiple bacterial infection（20.2%）.Among them,Gram-negative pathogens occupied 66.7%,Gram-positive were 22.4%,and fungi were 10.9%;the 5 common Gram-negative pathogens were pseudomonas aeruginisa,Escherichia coli,Kelbsiella pneumoniae,Acinetobacter baumannii and Enterobacter.Staphylococcus aureus,S.epidermidis and Enterococcus were 3 main pathogens in Gram-positive and Candida albicans was the most common in fungi, respectively.Most of them were multidrug resistant.Most strains of Gram-negative bacilli were highly susceptible to imipenem,while most strains of Gram-positive cocci were highly susceptible to Vancomycin.Conclusion Resistance detection of bacteria of lower respiratory tract infection in senile patients has an important significance to clinical treatment with drugs.