老年肺炎患者病原菌的分布及耐药性分析  

Pathogens in Senile Pneumonia Patients:Their Distribution and Resistance Analysis

作　　者：田华[1] 尚旭明[1] 

机构地区：[1]山东大学附属省立医院检验科,山东济南250021

出　　处：《中华医院感染学杂志》2009年第15期2051-2053,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨老年肺炎患者病原菌的分布及耐药状况，为临床合理应用抗菌药物提供帮助。方法对357例老年肺炎患者的痰标本，进行细菌培养鉴定及药物敏感试验，并对结果进行分析。结果共分离出病原菌291株，革兰阴性杆菌202株（69．4％），主要分离菌依次为铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、嗜麦芽寡养单胞菌、鲍氏不动杆菌等；革兰阳性球菌60株（20．6％），以金黄色葡萄球菌为主，占12．7％，MRSA占所分离金黄色葡萄球菌的72．8％；真菌29株（10．0％），以白色假丝酵母菌为主，占7．56％；药物敏感试验显示，所分离的病原菌对抗菌药物存在多药耐药性，不同病原菌对各种抗菌药物的耐药率差异较大；革兰阴性杆菌对氨苄西林耐药率最高，耐药率接近100．0％，对碳青酶烯类药物亚胺培南的耐药率最低，耐药率0～14．3％，肺炎克雷伯菌及大肠埃希菌ESBLs阳性率分别为56．5％和41．2％。结论老年肺炎患者的主要病原菌为革兰阴性杆菌，病原菌对抗菌药物存在多药耐药性，临床应根据药敏试验结果选择抗菌药物。OBJECTIVE To study the distribution and drug resistance of pathogens in pneumonia of aged, so that to help clinical therapy. METHODS Analyzing the distribution and resistance of the pathogenic bacteria isolated from 357 samples of senile pneumonia patients. RESULTS A total of 291 strains of bacteria included 202 （69.4%） of Gram-negative bacilli. The isolation rates of the main bacteria were; Pseudomonasaeruginosa 〉 Klebsiella pneumoniae 〉 Escherichia coli 〉 Acinetobacter baumannii. Sixty （20. 6%） strains of Gram-positive bacteria were isolated. Staphylococcus aureus was the most predominat pathogen （13. 0%）, meticillin-resistant S. aureus （MRSA） （72. 8%）. Twenty-nine （10. 0%） strains of fungi were isolated, Candida albicans was the most predominant （7. 56%）. The result of drug sensitive test showed that there were high rates of multiple drug resistance in most bacteria strains, but there were high different drug resistance rates to different antibiotics. Ampicillin had the highest resistance rate nearly 100%. In contrast, the imipenem resistance had the lower resistance rate from 0--14.3%. Lactamases （ESBLs） in K. pneumoniae and E. coli were 56.5% and 41.2%. CONCLUSIONS Gram-negitive bacteria are major pathogens in pneumonia of aged. There are high rates of multiple drug resistance in bacteria strains. The clinic should reasonably choose the antibiotics according to the test results of the pathogens sensitivity to drugs.

关 键 词：老年肺炎患者 病原菌 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]