攀枝花市某医院老年下呼吸道感染病原菌分布及耐药性分析

Analysis of Distribution and Drug Resistance Test of Pathogenic Bacteria of Lower Respiratory Infection in Elderly Patients in a Hospital in Panzhihua City

目的了解我院老年下呼吸道感染患者病原菌分布情况及耐药性。方法收集我院2012—2013年住院老年下呼吸道感染患者450例的痰标本进行细菌培养和药物敏感性分析。结果 450例痰标本病原菌培养阳性343例(76.2%),共检出病原菌367株,其中革兰阳性球菌71株(19.3%),革兰阴性杆菌272株(74.1%),真菌24株(6.5%)。主要革兰阴性杆菌对碳青霉烯类药物及β内酰胺酶抑制剂复合物的耐药率较低;主要革兰阳性球菌对青霉素、亚胺培南-西司他汀钠及红霉素均高度耐药,但对万古霉素及替考拉宁均不耐药。结论我院老年下呼吸道感染病原菌以革兰阴性杆菌为主,临床医生应根据细菌培养及药物敏感试验结果合理选用抗菌药物,减少耐药菌株的产生。

Objective To understand distribution and drug resistance of pathogenic bacteria in elderly patients with lower respiratory infection. Methods A total of 450 sputum specimens of elderly patients with lower respiratory infection in our hospital were collected during 2012 and 2013 for bacterial culture and drug resistance analysis. Results 367 pathogenic bacteria strains were detected out from 343 cases whose sputum culture results were positive （76. 2%, 343/450）. There were 71 strains （19. 3%） of gram positive coccus, 272 strains （74. 1%） of gram negative bacilli, and 24 strains （6. 5%） of fungus. The main gram negative bacilli strains were lowly resistant to carbapenems and Beta lactamase inhibitor complex; the main gram positive coccus strains were highly resistant to penicillin, erythromycin and imipenem/cilastatin sodium, but were not resistant to vancomycin and teicoplanin. Conclusion Gram negative bacilli is the main pathogenic bacteria in elderly patients with lower respiratory tract infection in our hospital. Clinicians should use antimicrobial agents reasonably according to the results of bacterial culture and drug sensitive test for improving clinical cure rate and reducing the resistant strains.