2012-2015年MICU老年脓毒症患者病原菌群分布及耐药性分析

Analysis on Distribution and Drug Resistance of MICU Elderly Patients with Sepsis from 2012 to 2015

目的探讨老年脓毒症患者病原菌的分布和耐药情况,为临床合理选用抗菌药物提供依据。方法回顾性分析137例老年脓毒症患者的细菌培养及药敏试验结果。结果 137例老年脓毒症患者中,94例患者为单一病原菌感染,28例死亡,病死率29.79%;43例患者为多重病原菌感染,26例死亡,病死率60.47%。共分离病原菌223株,其中革兰阴性菌132株(59.19%),以鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯杆菌、大肠杆希菌为主;革兰阳性菌84株(37.67%),以金黄色葡萄球菌和凝固酶阴性葡萄球菌为主,真菌29株(13.00%),以白色念珠菌为主;主要病原菌对临床常用抗菌药物表现出较高耐药率,且呈多重耐药性。结论老年脓毒症患者细菌耐药率情况十分严重,病原菌多为耐药菌,患者预后差,应予以重视。

Objective To study the distribution and drug resistance of elderly patients with sepsis, further providing the basis for the clinical rational use of drug. Methods The resuhs of bacterial cuhure and drug sensitive test of 137 cases of elderly patients with sepsis were analyzed, retrospectively. Results There were 94 patients with a single pathogen infection among 137 patients and 28 eases died （29.79%）. Other 43 patients with multiple pathogen infection and 26 eases died （60.47%） were counted. The 223 cultures which isolated from patients, there were 132 Gram negative -euhures（59.19% ） , primary pathogenic bacteria of that were Acinetobacter baumannii, Pseudomonas aeruginosa, K. pneumoniae and E. eoli, at the same time, there were 84 Gram positive cultures （37.67%） , ahead of them were Staphylococcus aureus and eoagulase - negative Staphylococcus （CNS） , and 29 strains of Fungs were isolated （ 13.00% ）. Funther more, the main pathogenic bacteria showed high resistance to the common antibiotics and presented multiple resistance. Conclusion Drug resistance rate of the elderly patients with sepsis is very severe, and the main pathogens are drug - resistant bacteria. There is poor prognosis in those elderly patients which should be paid attention to.