老年患者医院获得性肺炎的病原菌分布及耐药性分析  

Pathogen distribution and drug resistance of hospital acquired Pneumonia in senile patients

作　　者：杜伟华[1] 李曙平[1] 丁文茂[1] 姜辉[1] 

机构地区：[1]广州军区武汉总医院干部病房一科,湖北武汉430070

出　　处：《中国现代医学杂志》2009年第17期2644-2646,共3页China Journal of Modern Medicine

摘　　要：目的探讨老年患者医院获得性肺炎（HAP）的病原菌分布及其耐药性。方法对该院2003年1月-2007年1月92例老年HAP患者的临床资料、痰病原学培养及抗生素的耐药监测结果进行回顾性分析。结果检出致病菌152株：革兰氏阴性菌87株（57．23％），其中铜绿假单胞菌占28．29％、大肠埃希氏菌占11．84％、肺炎克雷伯氏菌占5．26％；苹兰氏阳性菌26株（23．4％），金黄色葡萄球菌占8．55％；真菌39株（17．6％）。革兰氏阴性菌对亚胺培南／西司他丁、阿米卡星敏感性较高，而对头孢他啶、头孢噻肟、头孢吡肟、左氧氟沙星等耐药率大都在46％以上。铜绿假单胞菌对多种抗菌药物敏感性下降。革兰氏阳性菌对头孢唑啉、头孢呋辛、环丙沙星、阿奇霉素等耐药率多在70％以上，对万古霉素敏感性高。结论老年患者医院获得性肺炎以革兰氏阴性杆菌为优势菌株，细菌耐药问题日趋严重，真菌感染呈上升趋势，值得关注。应根据药敏结果合理地选用抗生素。[ Objectives ] To investigate the distribution and resistance to antimicrobial agents of the pathogenic bacteria causing hospital acquired Pneumonia （HAP） in senile patients. [Method] Clinical data of senile patients with HAP from January 2003 to January 2007 were reviewed. The pathogen types and antibiotic sensitivity of pathogens isolated form cultured sputum collected from the senile patients were analyzed. [Result] A total of 152 strains of bacteria including 87 strains of Gram-negative bacteria （57.23%）, 26 strains of Gram positive bacteria （17.11%）, 39 strains of fungi （25.66%） were collected. Pseudomonas aeruginosa （28.29%）, Eseherichia coli （11.84%）, Staphylococcus Aureus （8.55%） were the main mico organizm. The effective agents against Gram-negative bacteria were Imipenem / Cilastatin, Amikaein, while the drug resistance rate of Gram negative bacteria to Ceftazidime, Cefotaxime, Cefepime, Levofloxaein were above 40%. The activity of antibacterial agents against P. aeruginosa was coming down. The drug resistance rate of Gram-positive bacteria to Cephazolin, Cefuroxime, Ciprofloxacin, Azithromycin were above 70%, while most Gram positive bacteria were sensitive to Vancomycin. [Conclusion] Gram-negative bacillus are the dominant pathogen of HAP in senile patients. The drug resistance of bacteria has become a more serious problem than before. Increasing of fungi as an infection should bring great concern. The use of antibiotics should be properly selected based on drug sensitive tests.

关 键 词：病原菌 抗药性 医院获得性肺炎 老年患者 

分 类 号：R653.1[医药卫生—外科学]