老年患者革兰阴性杆菌性肺炎的菌群分布及耐药性

Flora distribution and antimicrobial resistance of gram-negative bacilli causing pneumonia in senile patients

目的调查老年患者革兰阴性杆菌性肺炎的菌群分布及耐药性,为临床医师合理用药提供科学依据。方法细菌培养和鉴定严格按照《全国临床检验操作规程》进行;药敏试验采用K-B法。结果 211株革兰阴性杆菌构成比依次为肺炎克雷伯菌占28.0%、铜绿假单胞菌占20.9%、大肠埃希菌占15.6%、鲍氏不动杆菌占10.0%等;主要革兰阴性杆菌对常用抗菌药物均产生了耐药性,肠杆菌科细菌对碳青霉烯类抗菌药物100.0%敏感,而铜绿假单胞菌及鲍氏不动杆菌对碳青霉烯类抗菌药物已产生了11.4%～14.3%的耐药率。结论老年患者革兰阴性杆菌性肺炎的病原菌耐药性不断增强,应加大监测与控制力度。

OBJECTIVE To investigate flora distribution and antimicrobial resistance of gram-negative bacilli causing pneumonia in senile patients and provide the scientific evidence for clinically reasonable use of antibiotics.METHODS Referring to National Guide to Clinical Laboratory Procedures,bacterial cultivation and identification were performed;the susceptibility testing was carried out by K-B methods.RESULTS A total of 211 strains of gram-negative bacilli consisted of K.pneumouia（28.0%）,P.aeruginosa（20.9%）,E.coli（15.6%）,and A.baumannii（10.0%）;the main gram-negative bacilli have produced resistance to common antibiotics except for 100.0% susceptibility of carbapenems antibiotics against Enterobacteriaceae,the resistance rates of P.aeruginosa and A.baumannii to carbapenems antibiotics varied from 11.4% to 14.3%.CONCLUSION The antimicrobial resistance of gram-negative bacilli causing pneumonia in senile patients is increasing,it is necessary to strengthen the monitoring and controlling.