老年患者呼吸道感染病原菌分布及耐药性监测

Bacterial Distribution and Drug Resistance in Respiratory Tract Infection among Geriatric Patients

目的了解老年患者呼吸道感染的病原菌,分析其对常用抗菌药物的耐药性。方法对2006年1月-2007年11月老年患者的9848份痰和咽拭子标本经常规细菌培养分离到的病原菌种类进行耐药性分析。结果老年患者呼吸道感染共检出病原菌3867株,检出率为39.3%,其中革兰阴性杆菌占67.9%,其次为真菌,占29.9%,革兰阳性球菌占2.2%;革兰阴性杆菌对头孢呋辛、庆大霉素、磺胺甲噁唑/甲氧苄啶、环丙沙星等有较高的耐药性,对亚胺培南、美罗培南较为敏感;革兰阳性球菌对万古霉素、米诺环素、呋喃妥因较为敏感。结论老年患者呼吸道感染以革兰阴性杆菌为主,且存在比较严重的耐药情况,真菌感染也不容忽视,临床应及早进行痰标本的细菌培养和对抗菌药物的耐药性监测,对指导临床合理用药至关重要。

OBJECTIVE To investigate the pathogens causing respiratory tract infection among the aged people,and analyze their drug resistance to antibiotics.METHODS The sputum samples of the old patients with respiratory tract infection were collected from Jan 2006 to Nov 2007,and the drug resistance of the pathogens isolated by routine bacterium culture were analyzed.RESULTS Totally 3867 pathogen strains were detected among the aged people with respiratory tract infection.The detected rate was 39.3%,from them the Gram-negative bacteric were 67.9% followed by the fungi,which accounted for 29.9%and Gram-positive cocci accounted for 2.2%.For example the Gram-negtive bacilli were resistante to cefuroxime gentamicin,trimethoprim/sulfa methoxazole and ciprofloxacin,but more susceptive to imipenem and meropenem.Staphylococcus were sensitive to vancomycin,minocycline and nitrofurantoin.CONCLUSION Gram-negative bacilli are the major pathogens causing respiratory tract infection among the old patients and highly resistant to a lot of antibiotics,but the fungal infection can not be ignored.The drug resistance monitoring to antibiotics and early bacterial culturing of the sputum samples are very important.