老年人口咽部带菌情况调查  

Oropharyngeal Bacterial Carriage in Elderly

作　　者：董蘅[1] 程梅芬[1] 顾静文[1] 王明贵[1] 

机构地区：[1]复旦大学附属华山医院,上海市200040

出　　处：《中国全科医学》2008年第10期912-913,922,共3页Chinese General Practice

基　　金：上海市卫生局老年医学与干部保健科研项目(2000GB04)

摘　　要：目的了解老年人口咽部细菌携带及其耐药情况、细菌携带的危险因素，以利于老年人呼吸道感染的防治。方法以无菌0．9％氯化钠溶液漱口后，采集咽拭子，进行细菌培养及鉴定。以纸片扩散法进行药敏测定。结果501例老年人口咽部的细菌携带率为32．1％（161／501）；获分离菌161株，其中革兰阴性杆菌147株（91．3％），革兰阳性球菌14株（8．7％）。前3位分离菌为嗜血杆菌属、肺炎克雷伯杆菌及金黄色葡萄球菌。98株嗜血杆菌属对氨苄西林、头孢唑啉、头孢呋辛、头孢噻肟的敏感性高，敏感率为94．9％～100．0％。40株肺炎克雷伯杆菌对头孢唑啉、头孢呋辛、头孢噻肟及庆大霉素的敏感率均为100．0％，对哌拉西林及环丙沙星的敏感率为95．0％～97．5％。10株金葡菌中80．0％对甲氧西林敏感。多因素回归分析显示，口腔装有义牙是老年人口咽部带菌的危险因素。结论老年人口咽部细菌携带率高，主要携带菌为嗜血杆菌属、肺炎克雷伯杆菌等革兰阴性杆菌，口腔义牙是老年人口咽部带菌的危险因素。Objective To investigate the bacterial carriage in oral pharynx, its drug resistance and the risk factors of the bacterial carriage in aged poeple. Methods Oropharyngeal swabs were taken from 501 aged people to culture bacteria after their mouths being rinsed with sterile saline. Antimicrobial susceptibility testing was carried out with disk diffusion method. Results The rate of oropharygneal bacterial carriage was 32. 1%（ 161/501 ） in all of the 501 aged people. 161 bacteria were isolated including 147 strains of gram - negative bacilli （91.3%）, 14 strains of gram - positive cocci （8.7%）. The numbers of Haemophillus spp, Klebsiella pneumoniae and Staphylococcus anreus were the three biggest in all. 98 strains of Haemophillus spp were highly susceptible to ampicillin, cefaclor and cefotaxime （94. 9% to 100. 0% ）. All of the 40 strains of K. pneumoniae were susceptible to cefuroxime, cefotaxime and gentamicin （ 100. 0% ）, and 95.0% -97. 5% to piperacillin and ciprofloxacin. 80. 0% of 10 strains of S. aureus were susceptible to methicillin. Multiple factor regression analysis indicated that oral artificial tooth was a main risk factor of the oropharyngeal bacterial carriage in elderly. Conclusion The rate of oropharyngeal bacterial carriage is high in elderly. The major colonized bacteria are gram - negative bacilli such as Haemophillus spp and K. pneumoniae. Oral artifial tooth is a main risk factor of the oropharyngeal bacterial carriage in elderly.

关 键 词：老年人 细菌 口咽部带菌 嗜血菌属 

分 类 号：R378[医药卫生—病原生物学]