老年卧床患者肺部感染病原菌分布及耐药性分析

Distribution characteristics of pathogenic microorganisms in elderly bedridden patients with pulmonary infection and drug resistance analysis

目的分析老年卧床患者合并肺部感染的病原菌分布及其耐药性,为临床医生合理选择抗菌药物提供依据。方法回顾性分析2019年1月至2022年1月收治的236例老年卧床肺部感染患者的临床资料,对全部患者痰液标本进行细菌培养、菌种鉴定及药敏试验。结果236例卧床老年肺部感染患者共分离出198株病原微生物,其分布以革兰阴性菌为主(占73.74%)。排在前5位的病原微生物依次为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、金黄色葡萄球菌。药敏结果提示,鲍曼不动杆菌对亚胺培南和美罗培南耐药率分别为57.14%和54.76%,而铜绿假单胞菌对上述两种药物耐药率分别为33.33%和30.00%。肺炎克雷伯菌对亚胺培南和美罗培南耐药率均达10.71%,大肠埃希菌对碳青霉烯类抗生素仍高度敏感,耐药率为0。金黄色葡萄球菌中甲氧西林耐药菌株检出率57.14%,未检出万古霉素耐药菌株。结论老年卧床患者合并肺部感染的病原菌分布以革兰阴性菌为主,主要致病菌多具有耐药现象,因此,应结合药敏试验合理选择抗菌药物治疗。

Objective To investigate the distribution characteristics of pathogenic microorganisms in elderly bedridden patients with pulmonary infection and to analyze the drug resistance,thus providing evidence for the rational use of antibacterial agents.Methods The clinical data of 236 cases of elderly bedridden patients with pulmonary infection treated in our hospital during the period from January 2019 to January 2022 were retrospectively analyzed.All patients underwent sputum bacterial culture,strain identification and drug sensitivity test.Results A total of 198 strains of pathogenic microorganisms were isolated from 236 elderly bedridden patients with pulmonary infection,most of which were Gram-negative bacteria(73.74%).The top five strains were the AcinetobacteRBauman,Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,and Staphylococcus aureus.The drug sensitivity test results indicated that 57.14%and 54.76%of AcinetobacteRBauman strains were resistant to imipenem and meropenem,respectively.The resistance rates of Pseudomonas aeruginosa strains to imipenem and meropenem were 33.33%and 30.00%,respectively.The resistance rates of Klebsiella pneumoniae strains to imipenem and meropenem were both 10.71%.Escherichia coli strains were highly sensitive to carbapenems,with the drug resistance rate of 0.A total of 57.14%of Staphylococcus aureus strains were resistant to methicillin.Vancomycin-resistant strains were not detected.Conclusion The pathogenic microorganisms distribution in elderly bedridden patients with pulmonary infection are mainly Gram-negative bacteria,and drug resistance is a serious event in majoRpathogenic microorganisms.Therefore,rational use of antibacterial agents relies on drug sensitivity testing.