老年患者下呼吸道医院感染的病原菌分布及耐药性分析

Distribution and drug resistance of pathogenic bacteria causing lower respiratory tract nosocomial infections in senile patients

目的了解老年患者下呼吸道感染菌群分布及耐药性,为合理使用抗菌药物提供试验依据。方法对2011年1月-2012年6月医院>60岁的下呼吸道感染住院患者痰培养结果进行回顾性分析。结果共分离出病原菌1886株,其中革兰阴性杆菌1588株占84.2%,革兰阳性球菌213株占11.3%,真菌85株占4.5%,排名前5位病原菌依次为鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、金黄色葡萄球菌,分别占26.0%、15.5%、12.7%、8.0%、7.2%;革兰阴性杆菌对亚胺培南、美罗培南耐药率相对较低,革兰阳性球菌对万古霉素、替考拉宁敏感。结论根据老年患者医院感染的特点,尽可能地控制引起感染的环节,从而降低老年患者下呼吸道医院感染的发生,医院务必加强合理使用抗菌药物的管理工作,遏制病原菌耐药性的快速增长。

OBJECTIVE To understand the distribution and drug resistance of pathogenic bacteria causing lower respiratory tract infections in senile patients so as to provide basis for the rational use of antibiotics. METHODS The patients with lower respiratory tract infections aged over 60 years old, who were hospitalized from Jan 2011 to Jun 2012, were enrolled in the study , then the results of sputum cultures were retrospectively analyzed. RESULTS Of totally 1886 strains of pathogens isolated, there were 1588 （84. 2%） strains of gram-negative bacteria, 213 （11.3%） strains of gram-positive cocci , and 85 （4. 5%） strains of fungi. The Acinetobacter baumannii （26.0%）, Pseudomonas aeruginosa （15.5%） , Klebsiella pneumoniae （12.7%） , Escherichia coli （8.0%） and Staphylococcus aureus （7.2%） ranked the top five species of pathogens. The drug resistance rates of the gramnegative bacilli to imipenem and meropenem were low , the gram-positive cocci were susceptible to vaneomyein and teieoplanin. CONCLUSION Great importance should be attached to the links associated with the infections based on the features of the senile patients with nosocomial infections; to reduce the incidence of lower respiratory tract infections, it is necessary for the hospital to reasonably use antibiotics so as to restrain the rapid growth of bacterial resistance.