老年下呼吸道感染病原学特点及对策

Etiologic characteristics and therapeutic strategies of lower respiratory infections in the elderly

老年人群是下呼吸道感染的主要人群,发病率和死亡率都较高。随着年龄的增长,基础疾病增多,口腔、上呼吸道的定植菌增加,吞咽功能障碍发生率增高,导致吸入性肺炎发生率增高,从而导致老年人群下呼吸道感染致病菌的病原谱分布与总体人群相比出现差异,革兰阴性肠杆菌科细菌、铜绿假单胞菌、金黄色葡萄球菌和厌氧菌的比例增加。本文在介绍老年人群特点的基础上着重探讨下呼吸道感染病原学及细菌耐药特点,并引用相关指南提供最佳的抗菌药物治疗选择方案,为临床医师提供指导。

Older patients are the main population suffering from lower respiratory infections , which is of high incidence and mortality . Because of the increasing age , presence of one or more co-morbidities, colonization of bacteria in the oral cavity and upper respiratory tract, and high incidence of dysphagia , all these factors increase the occurrence of aspiration pneumonia .Thus, the distribution of causative agents for lower respiratory infection in the older people is different from general population .The percentages of Gram-negative Enterobacteriaceae, Pseudomonas aeruginosa, Staphylococcus aureus and anaerobic bacteria become larger .Based on the characteristics of the elderly population , this paper focused on the features of pathogens and bacterial resistance in lower respiratory tract infection, and provided the best antibiotic treatment options according to the relative guidelines so as to provide references to the clinicians.