老年患者医院获得性肺炎临床及致病菌特点分析

An examination of the spectrum characteristics of the bacteria engendering hospital-acquired pneumonia in elderly patients

目的分析老年患者医院获得性肺炎的临床特点及致病菌谱和耐药情况,指导临床上合理使用抗生素。方法对60例老年患者医院获得性肺炎的临床资料进行回顾性分析,明确菌群特点及药敏情况。结果 748例老年住院患者中有60例发生医院内获得性肺炎,感染率为8.0%。60例患者痰标本共培养出病原菌73株,其中革兰阴性菌55株(75.3%),革兰阳性菌10株(13.7%),真菌8株(11.0%)。革兰阴性菌中以铜绿假单胞菌(32.9%)、鲍曼不动杆菌(13.7%)、大肠埃希菌(11.0%)、肺炎克雷伯菌(9.6%)。革兰阳性菌中金黄色葡萄球菌占12.3%。致病菌对目前使用的抗生素普遍出现严重耐药。结论老年患者医院获得性肺炎致病菌以革兰阴性菌为主,耐药严重。应根据药敏试验指导使用抗生素,以降低老年患者医院获得性肺炎的病死率。

Objective The study was intended to obtain knowledge for scientific use of antibiotics by examining the spectrum characteristics and drug resistance of the bacteria that engender hospital-acquired pneumonia in elderly patients. Method 60 elderly patients with hospital-acquired pneumonia out of 748 elderly patients admitted to hospital were selected as an experimental group were for the study. The relevant clinical data, the spectrum characteristics and drug resistance of the bacteria in question were studied. Results Out of the 748 elderly patients, 60 were found to suffer hospital- acquired pneumonia, i.e. the infection rate was 8.02%. 73 strains of pathogens were successfully isolated, with 55 strains of Gram-negative bacterium, 10 strains of Gram-positive and 8 strains of Fungi. Pseudomonas aeruginosa, a. baumanii, Klebsiella pneumoniae bacteria, and escherichia coli are the major constituents of Gram-negative bacterium, with 24 strains of Pseudomonas aeruginosa accounting for 32.88%. Staphylococcus aureus （8 strains, accounting for 10. 96% ） were the major constituents of the Gram- positive bacterium. Current use of antibiotic gives rise to serious resistance in all pathogenic bacteria. Conclusion The study exposed that Gram-negative bacteria are the major pathogenic bacteria for hospital-acquired pneumonia in elderly patients and have strong resistance to antibiotics. Use of antibiotics according to antimicrobial susceptibility test should be recommended. Scientific measures to reduce hospital-acquired pneumonia mortality of elderly patients should be established.