呼吸内科老年患者下呼吸道感染病原菌分布及其耐药性分析

Distribution of Pathogenic Bacteria and Their Drug Resistance in Lower Respiratory Tract Infections in Elderly Patients of Respiratory Medicine

目的研究呼吸内科老年患者下呼吸道感染病原菌分布及其耐药性,利于为合理使用抗生素提供参考依据。方法选取该院2017年1月—2019年12月收治的96例老年下呼吸道感染住院患者为研究对象,患者感染的病原菌进行培养、分离及鉴定,病原菌耐药性利用K-B琼脂法分析。结果革兰阳性菌55株,占比45.83%;革兰阴性菌61株,占比50.83%;真菌4株,占比3.33%;革兰阳性菌对利奈唑胺、替莫唑胺有较低耐药率,耐药率未超过10.00%,对青霉素G、氨苄西林、红霉素、环丙沙星及氧氟沙星有较高耐药率,耐药率超过50.00%;革兰阴性菌对亚胺培南、替考拉宁有较低耐药率,耐药率未超过10.00%,对土霉素、红霉素、头孢呋辛、氨苄西林及阿莫西林有较高耐药率,耐药率超过40.00%;真菌对制菌霉素、灰黄霉素有较低耐药率,耐药率是0.00%,对酮康唑、益康唑、咪康唑及两性霉素B有较高耐药率,耐药率超过50.00%。结论下呼吸道感染在医院较常见,鉴定病原菌并实行药敏试验,可协助医师选择耐药率较低的抗生素,保证患者用药安全、可充分发挥药效,值得推崇。

Objective To study the distribution of pathogenic bacteria and their drug resistance in lower respiratory tract infections in elderly patients in the Department of Respiratory Medicine,so as to provide a reference for the rational use of antibiotics.Methods 96 elderly inpatients with lower respiratory tract infection admitted to the hospital from January 2017 to December 2019 were selected as the subjects of study.The pathogenic bacteria infected by the patient were cultured,isolated and identified,and the drug resistance of the pathogens was analyzed by the K-B agar method.Results There were 55 strains of Gram-positive bacteria,accounting for 45.83%.61 Gram-negative bacteria,accounting for 50.83%.4 strains of fungi,accounting for 3.33%.Gram-positive bacteria had a low resistance rate to linezolid and temozolomide,and the resistance rate did not exceed 10.00%.It had a high resistance rate to penicillin G,ampicillin,erythromycin,ciprofloxacin and ofloxacin,and the resistance rate exceeds 50.00%.Gram-negative bacteria had a low drug resistance rate to imipenem and teicoplanin,and the drug resistance rate does not exceed 10.00%.It was relatively resistant to oxytetracycline,erythromycin,cefuroxime,ampicillin and amoxicillin.high drug resistance rate,drug resistance rate exceeds 40.00%.Fungi had a low resistance rate to bacterostomycin and griseofulvin,and the resistance rate was 0.00%.It had a high resistance rate to ketoconazole,econazole,miconazole and amphotericin B,and the resistance rate exceeded 50.00%.Conclusion Lower respiratory tract infections are common in hospitals.The identification of pathogenic bacteria and the implementation of drug susceptibility tests can assist physicians in choosing antibiotics with lower drug resistance rates,ensuring the safety of patients'medications and giving full play to their efficacy.It is worthy of praise.