老年社区获得性肺炎病原菌调查及耐药性分析  

Analysis on Etiology and Antimicrobial Resistance of Old Patients with Community Acquired Pneumonia

作　　者：许志金[1] 张萌[2] 周芳玲[1] 周光悦[1] 

机构地区：[1]广西壮族自治区民族医院急诊科,530001 [2]中山大学附属第二医院急诊科

出　　处：《岭南急诊医学杂志》2009年第5期353-355,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:通过分析社区获得性肺炎(CAP)老年患者痰培养及药敏试验,了解当前CAP病原菌的分布及耐药情况。方法:分析2008年1月～12月我院诊断为老年社区获得性肺炎住院患者送检的73例痰培养的病原菌及药敏试验。结果:73例中共分离出病原菌60株,17个菌种。其中革兰氏阴性杆菌占79%,革兰氏阳性球菌占21%,7例阳性标本中同时培养出真菌,占12%。革兰氏阴性杆菌对亚胺培南仍有高敏感性(95%～100%),其次对头孢哌酮/舒巴坦钠、头孢噻肟、左旋氧氟沙星、丁胺卡那霉素等敏感性也较高(67%～89%),对氨苄西林耐药性最高达95%。而革兰氏阳性球菌对万古霉素的敏感性高达100%,对氨苄西林的耐药性亦高达80%。结论:引起老年社区获得性肺炎的致病菌以革兰氏阴性杆菌为主,对头孢哌酮/舒巴坦钠、头孢噻肟、左旋氧氟沙星、丁胺卡那霉素等药物敏感,而对氨苄西林、头孢唑林、头孢呋辛、阿奇霉素等耐药性高。Objective:To investigate the disposition of pathogens and the drug resistance of isolated bacteria through analyzing sputum culture and susceptibility test from the old patients with community acquired pneumonia (CAP).Method:Analyzing sputum culture and susceptibility test from 73 old patients diagnosed CAP from Jan 2008 to Dec 2008.Results:There were 60 stocks and 17 strains of pathogenic bacteria isolated from 73 cases. Gram-Negative bacillus accounted for 79% and Gram-Masccline bacillus 21%.7 cases were also cultured eumycete in Gram-Masccline bacillus,which accounted for 12%.Gram-Negative bacillus had hypersensivity to imipenem(95% ～100%),then were Cefoperazone/Sulbactam,Cefotaxime,Levofloxacin,Amikacin (67%～89%).The drug resistance rate of Gram-Negative bacillus to Ampicillin was 95%.The drug sensitive rate of Gram-Masccline bacillus to Vancomycin was 100% and the drug resistance rate to Ampicillin was 80%.Conclusion:The pathogenic bacteria caused CAP mainly is Gram-Negative bacillus.They are sensitive to Cefoperazone/Sulbactam,Cefotaxime, Levofloxacin,Amikacin and resistance to Ampicillin,Cefazolin,Cefuroxime and Azithromycin.

关 键 词：老年社区 社区获得性肺炎 肺炎病原菌 调查 耐药性分析 Antimicrobial Resistance 革兰氏阴性杆菌 革兰氏阳性球菌 左旋氧氟沙星 丁胺卡那霉素 氨苄西林 高敏感性 药敏试验 头孢噻肟 头孢哌酮 舒巴坦钠 痰培养 住院患者 药物敏感 阳性标本 

分 类 号：R563.1[医药卫生—呼吸系统]