老年患者下呼吸道感染病原菌分布及耐药性分析  

ANALYSIS ON BACTERIAL DISTRIBUTION AND DRUG RESISTANCE IN LOWER RESPIRATORY TRACT INFECTION DISEASE AMONG SENILE PATIENTS

作　　者：郭珊[1] 马茹[1] 王谦[1] 

机构地区：[1]河南新乡市中心医院,新乡453000

出　　处：《现代预防医学》2010年第3期600-600,F0003,共2页Modern Preventive Medicine

摘　　要：[目的]探讨老年患者下呼吸道感染常见病原菌的分布及耐药状况,为临床合理用药提供依据。[方法]对2004年1月～2005年12月2年间629例下呼吸道感染的老年患者痰及下呼吸道分泌物进行常规细菌培养,用美国德灵公司MicroScanautoSCAN4型微生物全自动分析仪对分离的纯菌株进行菌株鉴定和药敏试验。[结果]老年患者下呼吸道感染病原菌以革兰阴性杆菌为主,占72.7%,革兰阳性球菌占16.4%,真菌占11%;细菌学培养阳性前5位是:肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、金黄色葡萄球菌及真菌。革兰阳性球菌中,只有万古霉素未发现耐药菌株,革兰阴性杆菌中,亚胺培南、头孢哌酮/舒巴坦敏感率较高,对其他抗菌药物均已产生了较高的耐药性。[结论]老年患者下呼吸道感染病原菌以革兰阴性杆菌为主,且细菌耐药性明显增多,临床应积极开展下呼吸道分泌物细菌培养及药敏试验,根据药敏结果,合理选用抗生素。[Objective] To investigate the bacterial distribution and drug resistance in lower respiratory tract disease among senile patients and to provide data for clinical treatment.[Methods] The sputum and secretion of lower respiratory tract were collected from 629 senile patients who were diagnosed with lower respiratory tract infection patients from 2004 to 2005.A11 the specimen were given identification and antibiotic resistance with Microscan Auto SCANT4.[Results] Among the strains of pathogens,Gram-negative bacilli was 72.7%,Gram-positive 16.4%,and eumycete 11%.The most common five kinds were Klebsiella pneumonia,Pseudomonas aeruginosa,Escherichia coli,S.aureus and eumycete.The drug sensitivity results showed that all the strains were highly resistant to commonly used antibiotics.No vancomycin-resistant strains were found in Gram-positive bacilli.Imipenem,cefazolin and cefoperazone /sulbactam had high sensitivity to Gram-negative bacilli.[Conclusion] The most common strains of the specimen from aged patients of lower respiratory tract infection disease are Gram-negative bacilli and have highly resistance to common and antibiotics.Identification and antibiotic resistance of the secretion of lower tract must be strengthened,and give the effective data for clinician.

关 键 词：老年患者 下呼吸道 病原菌 革兰阴性杆菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]