贵阳地区老年人社区获得性肺炎的病原学分析

Analysis of Pathogens of Elderly Patients with Community-acquired Pneumonia

目的:分析贵阳地区老年人社区获得性肺炎(CAP)的病原菌分布。方法:收集住院的488例老年CAP患者病历资料,记录入院前抗菌药物用药史、伴随疾病、入院后痰培养结果,分析痰培养阳性的老年CAP患者病原菌分布及药敏结果。结果:488例老年CAP患者中398例患者合并至少一种慢性基础疾病,278人在入院前使用了抗菌药物,行痰培养者270例,共分离123株病原菌,单一感染者78例,2种以上感染者22例。药物敏感试验结果表明鲍曼不动杆菌耐药率较高,非发酵菌属耐药率较低。结论:贵阳地区老年CAP患者病原菌以革兰阴性菌为主,对亚胺培南、左氧氟沙星、环丙沙星耐药率较低。

Objective： To analyze the pathogenic distribution of community-acquired pneumonia （CAP） among elderly patients of Guizhou and to provide a reference for empirical antibiotic therapy. Methods ： The medical records of 488 cases of elderly CAP patients hospitalized in the affiliated hospi- tal of Guizhou medical university from January 2014 to December 2014 were collected, their history of using antibacterials before hospitalization, associated condition and sputum culture results after admission were recorded, and pathogenic distribution and drug-sensitivity of elderly CAP patients with positive sputum culture were analyzed. Results： Among 488 cases of elderly patients with CAP, 398 cases of patients were combined with at least a chronic underlying disease, and 278 patients had used anti- bacterials before admission. 270 cases underwent sputum culture, and a total of 123 strains of pathogens were isolated, among which 78 cases belonged to single pathogen and 22 cases co-infected. Drugsensitivity results showed that Acinetobacter baumannii had high resistance rate, and non-fermenting bacteria had low resistance rate. Conculsion： The most common pathogen for CAP in Guizhou is gramnegative bacteria, which has relatively low resistence to imipenem, levofloxacin and ciprofloxacin.