老年革兰阴性杆菌性肺炎的病原菌耐药性分析

Distribution and drug resistance of gram-negative bacilli causing pneumonia in senile patients

目的探讨基层医院老年革兰阴性杆菌性肺炎的病原菌构成比及耐药性,为临床医师合理使用抗菌药物提供科学依据。方法细菌培养鉴定按照《全国临床检验操作规程》进行;药敏试验采用CLSI推荐的K-B法。结果老年肺炎患者分离的158株革兰阴性杆菌主要为铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、阴沟肠杆菌,分别占31.0%、25.9%、20.9%、12.0%;以上细菌对常用抗菌药物均产生了较严重的耐药性,铜绿假单胞菌甚至对碳青霉烯类抗菌药物亚胺培南、美罗培南也产生了耐药性,耐药率为14.3%、18.4%。结论基层医院医院感染的病原菌耐药性呈上升趋势,应采取综合性预防与控制措施。

OBJECTIVE To explore constitution ratio and antimicrobial resistance of gram-negative bacilli causing pneumonia in senile patients in a grass-root hospital and provide the scientific evidence for clinicians to rationally use antibiotics. METHODS Referring to National Guide to Clinical Laboratory Procedure,the pathogenic bacteria were cultured and identified.The antibiotic susceptibility testing was performed by K-B method recommended by CLSI. RESULTS Totally 158 strains of gram negative bacilli were isolated from senile patients with pneumonia,mostly including Pseudomonas aeruginosa（31.0%）,Klebsiella pneumoniae（25.9%）,Escherichia coli（20.9%） and Enterobacter cloacae（12.0%）.The above strains had developed serious resistance to commonly used antibiotics.Resistance rates of Pseudomonas aeruginosa to carbapenems antibiotics imipenem and meropenem were 14.3% and 18.4%,respectively. CONCLUSION The comprehensive prevention and control measures should be adopted to restrain the increasing tendency of bacterial resistance in grass-root hospitals.