198例老年人下呼吸道感染临床分析  

Clinical analysis of 198 elderly patients with lower respiratory infection

作　　者：刘艳平[1] 靳轶敏[1] 马丽[1] 

机构地区：[1]哈尔滨医科大学附属第一医院第二住院部,黑龙江哈尔滨150001

出　　处：《中国现代医学杂志》2006年第4期597-599,共3页China Journal of Modern Medicine

摘　　要：目的研究老年人继发下呼吸道感染的常见菌及药物治疗。方法选取并发下呼吸道感染、痰细菌培养阳性、60￣94岁的老年人198例,做菌种鉴定和药敏试验,并做统计分析。结果革兰氏阴性杆菌153株(77.2%),革兰氏阳性菌株21株(10.6%),真菌24株(12.2%)。耐药性:153株革兰氏阴性杆菌药敏结果为亚胺培南/西司他丁抗菌作用最强,其次为头孢他啶、环丙沙星,而大多数革兰氏阴性杆菌对多种β—内酰胺类抗生素具有高度耐药性(>75%)。21例革兰氏阳性杆菌对万古霉素均敏感,对三代头孢及阿米卡星、环丙沙星耐药。24例真菌感染者对大扶康敏感。结论本组研究结果提示老年人继发下呼吸道感染以革兰氏阴性杆菌为主,其次为革兰氏阳性菌和真菌。对革兰氏阴性杆菌亚胺培南/西司他丁抗菌作用最强,其次为头孢他啶、环丙沙星。革兰氏阳性杆菌万古霉素敏感。真菌大扶康敏感。铜绿假单胞菌、耐甲氧西林金葡菌、真菌在肺感染中占有重要的地位。[Objective ] To investigate the pathogenic bacteria in elderly patients with secondary lower respiratory infection for its drug treatment. [Methods] 198 elderly patients aging from 60 to 94 were selected under the standards of complicated lower respiratory infection and positive results in bacteria culture in sputum. Subsequently, bacterium identification and drug sensitivity screening were carried out and all the data was statistically analyzed, [Resuits] 153 sputum samples （77.2%） were found with Gram-negative bacillus infection, 21 samples （10.6%） indicated Gram-positlve bacteria existence and the pathogen in the rest 24 samples （12.2%） were proved to be fungus. Drug sensitivity screening showed that Imipenem/Cilastatin displayed the strongest effect on the 153 samples infected with Gram-negative bacillus while ceftazidime and ciprofloxacin were slightly weaker. However, in most cases （〉75%）, Gram-negative bacillus were highly resistant to β-intra-acidamide antibiotics. For 21 eases with Gram-positive bacteria, all of them showed the sensitivity to Vancomycin but resistant to tert-eephalospofin, amikacin and ciprofloxacin. The final 24 fungus infected cases were all sensitive to flueonazole. [Conclusion ] This study indicated that the secondary lower respiratory infection in elderly people was mainly caused by Gram-negative bacteria, which was mopt sensitive to Imipenem/Cilastatln with ceftazldime and ciprofloxacin following behind and Gram-positive bacteria and fungus that constitute the minority causes were sensitive to Vancomycin and fluconazole respec- tively. To be specific, pseudomonas aeruginosa, mcthicillin resistant staphylocoecus aureus and fungus were of great importance in pulmonary infection.

关 键 词：下呼吸道感染 细菌培养 耐药 

分 类 号：R56[医药卫生—呼吸系统]