老年肺部感染患者病原菌耐药性分析

Drug resistance of pathogens isolated from elderly patients with pulmonary infections

目的对老年肺部感染患者检出病原菌耐药性进行分析,为临床医师诊疗提供参考。方法选取2014年11月-2016年11月浙江医院呼吸内科收治的老年肺部感染患者326例,回顾性分析老年肺部感染患者临床资料,以明确患者临床特征、病原菌构成以及耐药性。结果 326例肺部感染患者共检出病原菌262株,其中革兰阴性菌212株,以铜绿假单胞菌、鲍氏不动杆菌和肺炎克雷伯菌为主,革兰阳性菌45株,以耐甲氧西林金黄色葡萄球菌为主;真菌主要为白假丝酵母;革兰阴性菌中铜绿假单胞菌、鲍氏不动杆菌和肺炎克雷伯菌均对氨苄西林/舒巴坦不敏感,对阿米卡星、亚胺培南、美罗培南较敏感;革兰阳性菌中耐甲氧西林葡萄球菌和肺炎链球菌对利奈唑胺、万古霉素及利福平敏感性较高。结论老年肺部感染患者主要致病菌为革兰阴性菌,主要革兰阴性菌对阿米卡星、亚胺培南、美罗培南敏感,主要革兰阳性菌对利奈唑胺、万古霉素、利福平较为敏感。

OBJECTIVE To investigate the drug resistance of pathogens isolated from elderly patients with pulmonary infections so as to provide guidance for clinical diagnosis and treatment.METHODS A total of 326 elderly patients with pulmonary infections who were treated in respiratory medicine department of Zhejiang Hospital from Nov 2014 to Nov 2016 were enrolled in the study,The clinical data of the elderly patients with pulmonary infections were retrospectively analyzed so as to define the clinical characteristics of the patients,distribution and drug resistance of the pathogens.RESULTS Totally 262 strains of pathogens were isolated from 326 patients with pulmonary infections,212 of which were gram-negative bacteria,and 45 were gram-positive bacteria;Pseudomonas aeruginosa,Acinetobacter baumannii and Klebsiella pneumoniae were dominant among the gram-negative bacteria,methicillin-resistant Staphylococcus aureus was the predominant species of the gram-positive bacteria,and Candida albicans was dominant among fungi.Among the gram-negative bacteria,the P.aeruginosa,A.baumannii and K.pneumoniae strains were not susceptible to ampicillin-sulbactam but were susceptible to amikacin,imipenem and meropenem.Among the gram-positive bacteria,the methicillin-resistant Staphylococcus and S.pneumoniae strains were highly susceptible to linezolid,vancomycin and rifampicin.CONCLUSIONThe gram-negative bacteria are dominant among the pathogens isolated from the elderly patients with pulmonary infections.The major species of gram-negative bacteria are susceptible to amikacin,imipenem and meropenem,and the major species of grampositive bacteria are susceptible to linezolid,vancomycin and rifampicin.