老年医院获得性肺炎患者病原菌监测及对策

Detection of pathogenic bacteria and countermeasure from hospital-acquired pneumonia in senile patients

目的研究老年患者医院获得性肺炎致病菌的分布及耐药情况,为老年医院获得性肺炎提供经验性选药依据。方法 2007-03-2009-03郑州大学第五附属医院住院患者,年龄>60岁,分离出致病菌的医院获得性肺炎患者共136例,进行致病菌的鉴定,采用纸片扩散法进行细菌药敏检测。结果 136例老年医院获得性肺炎患者共分离出致病菌208例,其中革兰阴性细菌占74.5%(155例),革兰阳性细菌占18.3%(例),真菌占7.2%。致病菌前三位分别为肺炎克雷伯菌,铜绿假单胞菌和大肠埃希菌。药敏结果显示革兰阳性菌和革兰阴性菌均耐药现象严重。结论老年医院获得性肺炎患者感染致病菌以革兰阴性菌为主,呈多重耐药,必须加强防治措施,并强调抗菌药物的合理应用。

Objective To study the distribution of pathogenic becteria of hospital-acquired pneumonia（HAP） in senile patients and their antibiotic resistance,and to instruct the clinic antibiotic treatment.Methods Patients aged over 60 years old,who were diagnosed of HAP with confirmed pathogens in our hospital,were putinto study.Pathogens were identified,then the antibiotic resistance was determined by Kirty-Baucer disk diffusion assay.Results There were 208 strains of pathogenic bacteria from 136 hospital-acquired pneumonia（HAP） in senile patients,including gram-negative bacteria accounted for 74.5%（155）,gram-positive bacteria accounted for 18.3%（38） and fungi 7.2%（15）.The first three pathogens were Klebsiella pneumonia、Pseudomonas aeruginosa and Escherichia coli.The results showed both gram-positive bacteria and gram-negative bacteria were high antibiotic resistant.Conclusions Gram-negative bacteria are the most comncon pathogens of hospital-acquired pneumonia（HAP） in senile patients,which present to multi-drug resistant pattern.Measures should be prevent,reasonable application of antibiotics should be emphasized.