高龄患者菌血症病原菌分布及与医院感染的关系探讨

Pathogens Distribution in Senile Patients with Septicemia and Its Relationship with Nosocomial Infection

目的探讨高龄患者血液感染的病原菌种类的分布及其与医院感染的关系。方法对医院两年来老年住院患者中196例菌血症患者的血培养阳性菌进行分类鉴定,并鉴别其与医院感染的关系。结果在分离的204株细菌中,革兰阴性菌、革兰阳性菌及真菌分别占25.49%、67.16%和7.35%;革兰阴性菌中以大肠埃希菌和铜绿假单胞菌为主;革兰阳性菌中以人葡萄球菌占优势,表皮葡萄球菌其次;真菌以近平滑假丝酵母菌为主;其基础疾病以肺部感染和各系统恶性肿瘤为主;血培养阳性196例患者中,发现125例患者合并医院感染,以肺部感染患者为主(78.23%)。结论机会致病菌,尤其革兰阳性菌是导致高龄患者发生菌血症的主要病原;恶性肿瘤和呼吸系统疾病患者易发生菌血症和并发医院感染,是治疗重点关注对象。

OBJECTIVE To investigate the pathogens distribution in senile patients with septicemia and its relationship with nosoeomial infection. METHODS The bacteria isolated from 196 senile patients with septicemia were cultured, identified, and analyzed their relationship with nosocomial infection. RESULTS Among the 204 bacterial strains, the percentage of Gram ^-, Gram^＋ bacteria and fungi were 25. 49%, 67. 16% and 7. 35%, respectively. Escherichia coli and Pseudomonas aeruginosa were predominant in Gram-bacteria, while Staphylococcus hominis and S. epidermidis in Gram^＋ bacteria and Candida parapsilosis in fungi. From 196 senile patients with septicemia 125 （78.23%） were found nosocomially infected, in which pulmonary diseases were the main clinical symptoms. CONCLUSIONS Opportunistic pathogens, especially Gram^＋ bacteria, are the main cause fob senile septicemia. Patients with malignant tumors and pulmonary diseases have the highest rates of septicemia and nosocomial infection, which impliy a special care.