高龄老人医院获得性肺炎病原菌构成及药敏特点

目的:研究我科高龄医院获得性肺炎(HAP)患者病原菌及耐药性,为早期经验治疗提供选药依据。方法:选取2011年1月-1日至2013年12月31日我科收治的高龄HAP患者176例,对病原菌及其耐药性进行回顾性分析。结果:共分离致病菌334株,其中G-菌239株(71.56%),G+菌68株(20.36%),真菌27株(8.68%)。前5种病原菌分别为铜绿假单胞菌102株(30.54%),金黄色葡萄球菌45株(13.47%),嗜麦芽窄食单胞菌38株(11.38%),鲍曼不动杆菌27株(8.08%),肺炎克雷伯菌18株(5.39%),普遍呈现多耐药性,尤以铜绿假单胞菌和鲍曼不动杆菌最明显。结论:综合医院干诊高龄患者HAP病原菌以革兰氏阴性菌为主,常呈多耐药性,及时掌握本地区常见病原菌及药敏情况,对早期经验治疗及其预后极为重要。

Objective： To analysis the distribution and drug resistance of pathogenic of hospital acquired pneumonia（HAP）in over 80 years patients, and to instruct the clinic antibiotic treatment.Methods： Retrospectively analyzed the commonly pathogenic and their antibiotic resistance of 176 elder patients with HAP in our ward from January 2011 to December 2013.Results： A total of 334 strains bacteria were isolated.Including Gram-negative bacteria accounted for 239 strains（71.56%）,Gram-positive bacteria accounted for 68 strains（20.36%）and fungi 27 strains（8.68%）.The top five pathogenic were Pseudomonas aeruginosa 102 strains（30.54%）,Staphylococcus anreus 45 strains（13.47%）,Stenotrophomonas maltophilia 38 strains（l 1.38%）,Acinetobacter baumannii 27 strains（8.08%）,Klebsiella pneumoniae 18 strains（5.39%）.Are showing the multi-drug resistance,Particularly Pseudomonas aemginosa and Acinetobacter baumannii obvious.Conclusion： Gram-negative bacteria are the main pathogens of elderly patients with HAP in general hospital general ward.The strains isolated are multiple drug-resistant.It is very important to study the characteristics and drug resistance of the pathogenic.