老年危重患者医院获得性肺炎细菌耐药性及感染相关因素分析

Analysis of bacterial drug resistance and infection related factors of the critical elderly patients infecting by hospital activity pneumonia

目的观察老年危重患者医院活动性肺炎细菌耐药性及感染相关因素。方法选取我院住院期间感染医院获得性肺炎的老年危重症患者为研究对象,并将痰标本送检,进行药敏试验分析,记录主要致病菌及其耐药性。结果 266例患者共培养72株病原菌,革兰阴性菌以铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌多见;革兰阳性菌以金黄色葡萄球菌多见;主要病原菌对临床常用抗菌药物的耐药性较高,但G-细菌对碳青霉烯类药物敏感性较高,G+细菌对糖肽类抗菌药物敏感性较高,合并基础性疾病,年龄较大,接触过肺炎患者,教育程度低,既往有吸烟、饮酒等是影响老年危重患者发生医院获得性肺炎的相关因素。结论老年医院获得性肺炎的病原菌以G-为主,G+次之,其耐药性均较高,故应重视抗生素的合理使用,减少耐药菌株的产生。

Objective To observate bacterial drug resistance and infection related factors of the critical elderly patients by hospital activity pneumonia. Methods The critically elderly patients infecting the hospital acquired pneumonia as the research object in our hospital were selected, and recorded the main pathogenic bacteria and drug resistance by the sputum culture and the drug sensitivity test. Results 72 strains of pathogenic bacteria were isolated in 266 patients, Pseudomonas aeruginosa, Klebsiella pneumonia, Acinetobacter baumannii ,Esche- richia coli were mostly contained in G- bacteria;Staphylococcus aureus was mostly contained in G ~ bacteria;the drug resistance of the main pathogenic bacteria to commonly antimicrobial was higher,the carbapenems was higher sensitivity to the G- bacteria,the glycopeptide anti- biotics was a high drug sensitivity to G ＋ bacterial,the related factors of critical elderly patients with hospital acquired pneumonia may be combined with basic diseases,older age, contact with pneumonia patients,low educational level,history of smoking or drinking and other fac- tors. Conclusion the main pathogens of hospital acquired pneumonia in the elderly was G- bacteria, G ~ bacteria was second,the drug re- sistance of them were both high,so the rational use of antimicrobial is important, and containment of bacterial resistance.