住院与非住院老年人口咽部带菌情况比较  

Comparison of oropharyngeal bacterial carriage in the hospitalized and non-hospitalized elderly people

作　　者：董蘅[1] 程梅芬[1] 卢燕雯[1] 顾静文[1] 

机构地区：[1]复旦大学附属华山医院国际医疗中心,上海200040

出　　处：《中国感染与化疗杂志》2008年第6期419-422,共4页Chinese Journal of Infection and Chemotherapy

基　　金：上海市卫生局老年医学与干部保健科研项目(2000GB04)

摘　　要：目的了解老年住院患者及非住院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。方法住本院老年科非感染患者及进行健康体检的上海市离、退休干部为调查对象,以无菌生理盐水漱口后,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。结果住院及非住院老年人口咽部的细菌携带率分别为55.2%(58/105)及32.1%(161/501),老年住院患者高于非住院老年人(P<0.01);携带菌中均主要为嗜血杆菌属,其次为肺炎克雷伯菌等革兰阴性杆菌。老年住院患者携带的肺炎克雷伯菌对各类抗菌药的敏感率低于非住院老年人。口腔装有义牙是住院及非住院老年人口咽部带菌的危险因素。结论老年住院患者口咽部细菌携带率高于非住院老年人,口腔义牙是老年人口咽部带菌的危险因素。Objective To investigate the oropharyngeal bacterial carriage in the hospitalized and non-hospitalized elderly people and their antibiotic resistance profile, as well as the risk factors for the bacterial carriage. Methods Hospitalized elderly patients without acute infections and healthy elderly persons during health examination were enrolled in this study. An oropharyngeal swab was taken from each subject after gargling with sterile saline. Bacteria were cultured and identified with routine methods and the antimicrobial susceptibility testing was carried out with disk diffusion method. Results The prevalence of oropharyngeal bacterial carriage was 55.2% （58/105） in the hospitalized and 32. 1 % （161/501） in the non-hospitalized elderly people （P〈 0. 001 ）. Gram-negative bacilli were the most common bacteria carried in both the hospitalized and non-hospitalized elderly people. The most common bacterial species were Haemophilus spp. , followed by Klebsiella pneumoniae. The K. pneumoniae isolates carried by hospitalized patients were less susceptible than those from the non-hospitalized elderly people. Logistic analysis indicated that denture wearing was the risk factor for the oropharyngeal bacterial carriage in both the hospitalized and non- hospitalized elderly people. Conclusions The prevalence of oropharyngeal bacterial carriage in the hospitalized elderly patients is high er than that in the non-hospitalized elderly people. Denture-wearing is the risk factor for oropharyngeal bacterial carriage in the elderly.

关 键 词：老年 细菌 口咽部带菌 嗜血杆菌属 

分 类 号：R446.5[医药卫生—诊断学]