摘要
目的对某基层医院老年患者下呼吸道感染病原菌的分布及耐药情况进行调查,为临床合理用药提供参考依据。方法对2016年1月—2017年12月收治的981例老年患者送检的下呼吸道标本进行病原菌培养及药敏试验,并对结果进行统计分析。结果共分离出病原菌702株,革兰阴性杆菌占74.6%,以肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌和铜绿假单胞菌较为常见;革兰阳性球菌占13.8%,以金黄色葡萄球菌和凝固酶阴性葡萄球菌多见;真菌占11.5%,以白色念珠菌多见。药敏结果显示肺炎克伯菌、大肠埃希菌、阴沟肠杆菌对亚胺培南、美罗培南、阿米卡星、哌拉西林/三唑巴坦的耐药率较低;鲍曼不动杆菌、铜绿假单胞菌对抗生素耐药较为严重,嗜麦芽寡养单胞菌对复方磺胺甲噁唑的耐药率最低,肺炎克雷伯菌、大肠埃希菌产ESBLs菌株的检出率为24.7%、42.3%。肺炎链球菌、金黄色葡萄球菌和凝固酶阴性葡萄球菌对万古霉素、利奈唑胺100.0%敏感,耐甲氧西林金黄色葡萄球菌(MRSA)、甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS)的检出率为33.9%、55.6%。结论老年患者下呼吸道感染病原菌以革兰阴性杆菌为主,病原菌对部分常用抗生素耐药严重,不同病原菌的耐药率相差较大,临床应根据药敏结果合理应用抗生素。
Objective To analyze the distribution and drug resistance situation of pathogenic causing lower respiratory tract infection among elderly patients in a certain basic hospital, and to provide the referenence for clinical rational drug use. Methods The culture and drug sensitivity test of pathogenic bacteria from 981 cases of lower respiratory tract specimens were carride out from January 2016 to December 2017 and the results were statistically analyzed. Results 702 pathogenic bacteria strains are totally separated, gram-negative bacili occupies 74.6%, which is mostly found in Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli and Pseudomonas aeruginosa; gram-negative bacili ocuppies 13.8%, which is mostly found in Staphylococcus aureus and Coagulase negative Staphylococcus; fungus occupies 11.5%, commonly found in Candida albicans. Results of drug sensitivity show the drug resistance rates of Klebsiella pneumoniae, Escherichia coli and Enterobacter cloacae against Imipenem, Meropenan, Amikacin, Piperacillin/tazobactam is lower; The antibiotics drug resistance of Acinetobacter baumannii and Pseudomonas aeruginosa is more severe. The drug resistance rate of Stenotrophomonas maltophilia against Sulfamethoxazole is the lowest. The dectectable rates to produce ESBLs bacterial strain from Klebsiella pneumoniae and Escherichia coli are 24.7% and 42.3%. In addition, the Streptococcus Pneumoniae, MRSA and MRCNS are 100.0% allergic to Vancomycin and Linezolid. Meanwhile, the dectectable rates of MRCNS from Methicillin are 33.9% and 55.6%. Conclusion The main pathogenic bacteria of elderly patients is gram-negative bacili, which has a severe drug resistance against partly widely used antibiotics. Big differences can be found from different pathogenic bacteria drug resistance, which requires us to intelligently use antibiotics according to the results of drug sensitivity.
作者
周荣财
朱光菊
赵德军
Zhou Rong-cai;Zhu Guang-ju;Zhao De-jun(People＇s Hospital of Xixiu District,Anshun 561000;The first People＇s Hospital of Qingzhen City,Qingzhen 551400)
出处
《国外医药（抗生素分册）》
CAS
2018年第6期544-548,共5页
World Notes on Antibiotics
关键词
老年患者
下呼吸道感染
病原菌
抗生素
耐药性
elderly patients
lower respiratory tract infection
pathogenic bacteria
antibiotics
drug resistance
