老年患者下呼吸道感染病原菌分布及耐药性分析

Distribution and drug resistance of pathogens in lower respiratory tract infection in elderly patients

目的研究老年患者下呼吸道感染病原菌分布及其耐药性。方法选择2015年7月~2016年6月期间收治的437例老年下呼吸道感染患者作为研究对象,对其痰液标本进行病原菌的分离鉴定,采用K-B法来进行细菌药敏检测。结果通过检测共分离出病原菌483株,其中有289株G^-菌,占总菌数量的59.8%,其中排名前4位的病菌类型为:铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌;真菌113株,主要类型为白色念珠菌;G^+菌81株,占总数的16.6%,金色葡萄球菌检出最多。在G^-菌当中舒巴坦/头孢哌酮以及盐酸左氧氟沙星和亚胺培南的耐药率相对较低;而G^+菌则对于利福霉素、亚胺培南的耐药率较低,对万古霉素的敏感度最高。结论老年患者下呼吸道感染检出最多的病原菌以G^-菌为主,部分病原菌具有耐药性,临床上应根据病原学检测结果进行治疗,以提高临床疗效。

Objective To study the distribution of pathogens and the drug resistance in the lower respiratory tract infection of the elderly patients.Methods A total of437elderly patients with lower respiratory tract infection were enrolled from July2015to June2016,the sputum samples of the pathogen isolation and identification,K-B method for drug susceptibility testing.and using K-B method to carry out drug sensitivity test.Results The detection of a total of483strains of bacteria were isolated,including289strains of G-,the total bacteria number59.8%,of which the top four types of bacteria:Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli and Acinetobacter Bauman;113strains of fungi,the main types of fungi were Candida albicans;81G+strains,accounting for16.6%of the total,which was the most bacteria species for Staphylococcus aureus.In the G-bacteria among sulbactam/cefoperazone and levofloxacin and imipenem resistance rate is relatively low;and G+bacteria for rifampicin.Imipenem resistance is low,but the highest sensitivity to vancomycin.Conclusion The elderly most pathogenic bacteria in G-bacteria of lower respiratory tract infection;Part of the pathogens with drug resistance,clinical treatment should be based on the results of pathogens to improve clinical efficacy.