2017—2020年宁夏某医院老年患者临床分离病原菌的耐药情况分析

Analysis of drug resistance of pathogenic bacteria isolated from elderly patients in a hospital in Ningxia from 2017 to 2020

目的 了解老年患者临床分离病原菌的耐药性,为老年患者临床合理使用抗菌药物提供理论依据。方法 利用微生物分离鉴定系统及常用药敏试验方法,对2017—2020年医院老年医学中心老年患者临床检出病原菌的耐药情况进行回顾性分析。结果 共分离病原菌518株,其中革兰阴性菌365株(70.46%),革兰阳性菌88株(16.99%),真菌65株(12.55%)。检出前5位的病原菌分别为大肠埃希菌、肺炎克雷伯菌、白假丝酵母菌、铜绿假单胞菌和鲍曼不动杆菌。肺炎克雷伯菌对碳青霉烯类抗菌药物的耐药率低于3.5%,未发现对碳青霉烯类耐药的大肠埃希菌株。铜绿假单胞菌对亚胺培南的耐药率为2.70%,未发现对美罗培南的耐药株。鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别高达60.00%和58.82%。结论 老年患者分离的病原菌主要以革兰阴性菌为主,其中鲍曼不动杆菌耐药性最为严峻,合理选用抗菌药物对老年患者具有重要意义。

Objective To understand the drug resistance of pathogenic bacteria isolated from elderly patients and to provide theoretical basis for rational use of antibiotics in elderly patients.Methods Using the microbial isolation and identification system and common drug sensitivity test methods,the drug resistance of pathogens detected in the elderly patients in the geriatric medical center of the hospital from 2017 to 2020 was retrospectively analyzed.Results A total of 518 strains of pathogenic bacteria were isolated,including 365 strains of gram negative bacteria(70.46%),88 strains of gram positive bacteria(16.99%) and 65 strains of fungi(12.55%).The top five pathogens were Escherichia coli,Klebsiella pneumoniae,Candida albicans,Pseudomonas aeruginosa and Acinetobacter baumannii.The resistance rate of Klebsiella pneumoniae to carbapenems was lower than 3.5%,and no resistant strain of Escherichia coli to carbapenems was found.The resistant rate of Pseudomonas aeruginosa to imipenem was 2.70%,and no resistant strain to meropenem was found.The resistance rates of Acinetobacter baumannii to imipenem and meropenem were 60.00% and 58.82%,respectively.Conclusion The gram-negative bacteria are the major pathogenic bacteria isolated from elderly patients over 60 years,and the drug resistance of Acinetobacter baumannii is the most serious.It is of great significance to rationally select antibiotics for elderly patients.