心力衰竭伴肺部感染老年患者影响因素及病原菌的耐药性监测

Influential factors of elderly patients with heart failure and pulmonary infection and drug resistance monitoring of pathogens

目的对心力衰竭伴肺部感染老年患者的影响因素及病原菌耐药性监测。方法回顾性分析1021例心力衰竭老年患者的资料。结果所有患者中伴肺部感染470例,检出病原菌696株;常见致病菌为革兰阴性杆菌497株,以肺炎克雷伯杆菌、铜绿假单胞菌、鲍氏不动杆菌、大肠埃希菌为主;其次是革兰阳性球菌182株,以肺炎链球菌、金黄色葡萄球菌、表皮葡萄球菌为主;真菌17株。鲍氏不动杆菌对头孢唑林、氨苄西林、复方新诺明,肺炎克雷伯杆菌对氨苄西林,铜绿假单胞菌对头孢唑林、氨苄西林耐药率达到100.0%;肺炎克雷伯杆菌对亚胺培南敏感度达到100.0%。结论该类患者常见致病菌耐药性高,应依照药敏试验用药。

Objective To observe the influencing factors of elderly patients with heart failure and pulmonary infection and the drug resistance monitoring of pathogens.Methods The data of 1021 elderly patients with heart failure were retrospectively analyzed.Results Among all the 470 patients with lung infection,696 pathogenic bacteria were detected;the common pathogenic bacteria were 497 strains of Gram-negative bacilli,mainly including Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,Escherichia coli,followed by 182 strains of Gram-positive cocci,mainly including Streptococcus pneumoniae,Staphylococcus aureus,Staphylococcus epidermidis;17 strains of fungi were detected.Acinetobacter baumannii showed 100%resistance to cefazolin,ampicillin,co-trimoxazole,Klebsiella pneumoniae to ampicillin,Pseudomonas aeruginosa to cefazolin,ampicillin;The sensitivity of Klebsiella pneumoniae to imipenem reached 100.0%.Conclusion The common pathogenic bacteria in these patients are highly resistant to drugs,and they should be used rationally according to the drug sensitivity test.