长沙某医院老年住院患者呼吸道样本的细菌分布及其耐药性

Distribution and drug resistance of bacteria isolated from respiratory tract specimens of elderly hospitalized patients in a hospital of Changsha

目的分析长沙某医院老年住院患者呼吸道样本的细菌分布及其耐药性,为临床合理使用抗菌药物提供依据。方法回顾性分析2015年1月-2020年12月长沙某医院61岁以上老年住院患者呼吸道样本细菌培养及药敏结果,统计分析细菌分布的年龄、性别差异性及常见抗菌药物的耐药变化趋势。结果17106份样本分离出3955株病原菌,检出率为23.1%,其中男性检出1951株,女性检出2004株;随着年龄增大,男性的检出率呈增加的趋势,61~90岁的女性则呈减少的趋势;鲍氏不动杆菌的耐药率普遍较高,呈广泛耐药趋势;铜绿假单胞菌的耐药率相对较低;肺炎克雷伯菌、大肠埃希菌和金黄色葡萄球菌的耐药率均较高。结论老年住院患者呼吸道样本病原菌检出主要以革兰阴性菌为主,且不同年龄阶段和性别分布有差异,老年男性发生呼吸道感染的易感性高于老年女性;多数病原菌的耐药率较高,尤其是对部分重要抗菌药物的耐药性呈逐年快速升高的趋势。

OBJECTIVE To investigate the distribution and drug resistance of bacteria isolated from respiratory tract specimens of elderly hospitalized patients in a hospital of Changsha so as to provide basis for reasonable clinical use of antibiotics.METHODS The respiratory tract specimens were collected form the elderly patients who were more than 61 years old and hospitalized in a hospital of Changsha from Jan 2015 to Dec 2020,the isolated bacteria were identified,and the result of drug susceptibility testing was retrospectively analyzed.The difference in the distribution of bacteria between ages and genders was statistically analyzed,and the changing trend of drug resistance to commonly used antibiotics was observed.RESULTS Totally 3955 strains of pathogens were isolated from 17106 specimens,with the isolation rate 23.1%,1951 of which were isolated from male patients,and 2004 were isolated from female patients.With the increase of age,the isolation rate of male patients showed upward trend,while the isolation rate of the female patients aged between 61 and 90 years old showed downward trend.The drug resistance rates of Acinetobacter baumannii strains were generally high,and the strains were pandrug-resistant;the drug resistance rates of Pseudomonas aeruginosa strains were relatively low;the drug resistance rates of Klebsiella pneumoniae,Escherichia coli and Staphylococcus aureus strains were relatively high.CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the elderly hospitalized patients with respiratory tract infection,there is difference in the distribution of pathogens between ages and genders.The elderly male patients are at higher susceptibility to respiratory tract infection than the elderly female patients.Most of the pathogens are highly drug-resistant,and the drug resistance rates to some key antibiotics are rapidly increase year by year.