老年下呼吸道感染的病原菌分布及耐药性分析

Distribution and drug resistance of pathogens for lower respiratory tract infection of elder patients

目的统计分析老年下呼吸道感染病原菌的分布及耐药情况。方法对入院469例老年下呼吸道感染患者痰标本进行病原菌分离鉴定及K-B法药敏检测。结果共分离出554株病原菌。其中G-菌339株(61.2%),前四位为铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌;G+菌69株(12.5%),以金黄色葡萄球菌居多;真菌146株(26.4%),以白色念珠菌为主。G-菌对亚胺培南、左氧氟沙星、头孢哌酮/舒巴坦耐药率低;G+菌对万古霉素最敏感,对利福平及亚胺培南耐药率低。结论老年下呼吸道感染病原菌以G-菌为主;一些病原菌耐药性较强,临床治疗应进行病原学检测,合理应用抗生素,控制细菌耐药性的增长。

Objective To investigate the distribution and drug resistance of pathogens isolated from lower respiratory tract infection of elder patients. Methods Isolated and identified pathogens from 469 elder patients with lower respira- tory tract infection, K-B tests were used to detect antidrug susceptibility. Results A total of 554 strains of bacteria were identified, including 339 （61.2%） strains of Gram-negative bacilli （the top four were Pseudomonas aeruginosa, Klebsiella pneumonia, Escherichia coli and Acinetobacter baumannii）, 69（12.5%） strains of Gram-positive bacilli（most of them were Staphylococcus aureus） and 146（26.4%） strains of fungi （most of them were Candida albicans）. Imipenem, levofloxacin and cefoperazone/sulbactam showed lower drug resistance rates to Gram-negative strains; vancomycin was the most sensitive one to Gram-positive strains and rifampicin and imipenem showed lower resistance rates to Gram- positive strains. Conclusion Most of the pathogens isolated from lower respiratory tract infection of elder patients was Gram-negative bacilli, some of the pathogens were highly drug-resistant, accurate pathogen detection and rational use of antibiotics were necessary to control the growth of bacterial resistance.