下呼吸道感染老年患者病原菌检测、耐药性及预后探讨

The pathogen detection,drug resistance and prognostic analysis of aged patients with lower respiratory infection

目的:探讨下呼吸道感染老年患者病原菌检测、耐药性及预后的影响因素。方法:对635例下呼吸道感染住院老年患者的临床资料进行回顾性探讨。结果:共分离病原菌225株,下呼吸道感染老年患者常见病原菌主要是革兰阴性(G-)杆菌139株,其次是G+球菌57株、真菌(念珠菌)29株;常见病原菌耐药性较高;经临床住院综合治疗,采取有效的预防和护理措施,235例治疗后痊愈,364例病情有所好转,30例治疗无效,6例治疗后最终死亡;预后主要影响因素是重视并加强临床护理及心脑血管病、糖尿病、多脏器功能衰竭等。结论:由于下呼吸道感染老年患者常见病原菌耐药性较高,应合理用药;有效的预防和护理措施及心脑血管病、糖尿病、多脏器功能衰竭等是影响其预后主要因素,临床应积极防治并加强护理,改善预后。

Objective：To investigate the pathogen detection,drug resistance and prognostic factors of aged patients with lower respiratory infection（LRI）.Methods：The clinical data of 635 aged patients with LRI were analyzed retrospectively.Results：225 pathogens were isolated from 635 aged patients,the common pathogens of aged patients with LRI were mainly gram negative（G-） bacteria（139）,followed by G＋ cocci（57）,fungi（candida,29）.Common pathogens had high drug resistance.After clinical comprehensive treatment in hospital with effective preventive and care measures,235 cases were cured,364 cases were improved,30 cases failed in treatment,6 cases were dead finally.The main prognostic factors were clinical care and cardiovascular disease,diabetes,multiple organ failure,etc.Conclusion：The common pathogens in aged patients with LRI had high drug resistance,so rational use of drug should base on susceptibility test results.Effective prevention and care measures,cardiovascular diseases,diabetes and multiple organ failure were the main factors affecting the prognosis.Active control and enhancement of clinical care can improve prognosis.