老年下呼吸道感染病原菌及其耐药性分析

Pathogens and Their Drug Resistance in Senile Patients with Lower Respiratory Tract Infection: A Clinical Investigation

目的 研究老年下呼吸道感染病原菌、耐药性及超广谱 β 内酰胺酶 (ESBLs)的阳性率。方法 应用常规痰细菌培养方法检出病原菌 ,用单纸片扩散法检测药敏 ,以双纸片协同试验法确定ESBLs阳性菌株。结果 共分离出致病菌 5 98株 ,其中G-菌 4 39株 ,占 73.4 % ,以铜绿假单胞菌、不动杆菌为主 ;对常用抗生素具有较高的耐药性 ;ESBLs总阳性率为 2 0 .9% ,其中大肠埃希菌为 16 .2 % ,肺炎克雷伯菌为 2 6 .2 %。结论 老年下呼吸道感染以G-菌为主 ,而且耐药性较强 ,今后应加强病原菌及药敏监测 ,以指导临床科学使用抗菌药物。

OBJECTIVE To investigate the distribution causing lower respiratory tract infection and drug resistance of bacteria and the prevalence of the bacteria producing extended spectrum β lactamases ( ESBLs ) . METHODS The susceptibility to antimicrobial agents was studied with diffusion method on Mueller Hinton medium. The double disk test for ESBLs confirmed all putative ESBLs producing strains. RESULTS A total of 598 strains were obtained from lower respiratory tract in senile patients. From them 439 strains were Gram negative bacilli, the predominant pathogens were Pseudomonas aeruginosa. The susceptibility test showed the resistance of bacteria were markedly increased. Twenty nine isolates of 139 strains Escherichia coli and Klebsiella pneumoniae were ESBLs producing(20.9%). CONCLUSIONS The Gram nagative bacilli were the major pathogens isolated from senile patients with lower respiatory tract infection. The monitoring should be enhanced to give suggestions to rational use of antibiotics.