老年呼吸机相关性肺炎的病原菌分布及耐药监测  

Distribution and Drug-resistance of Pathogens in Geriatric Patients with Ventilator-associated Pneumonia

作　　者：吴丽丽[1] 魏凌云[1] 叶友仙[1] 沈世恩[1] 于小妹[1] 

机构地区：[1]浙江医院检验科,浙江杭州310013

出　　处：《中华医院感染学杂志》2010年第8期1172-1174,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨老年呼吸机相关性肺炎(VAP)的病原菌分布及其耐药性,为临床抗菌药物的正确应用提供参考。方法对病房使用呼吸机的161例老年患者进行目标性监测,病原学检查和病原菌对抗菌药物耐药性结果进行回顾性分析。结果82例老年患者检出215株病原菌,其中革兰阴性菌占73.95%,革兰阳性菌占15.82%,真菌占10.23%;革兰阴性菌中鲍氏不动杆菌20.47%、铜绿假单胞菌19.53%、肺炎克雷伯菌14.88%、嗜麦芽寡养单胞菌13.95%为主要致病菌;革兰阳性菌中以金黄色葡萄球菌8.84%为主;假丝酵母菌属仍为真菌感染的主要致病菌;病原菌对常用抗菌药物的耐药性普遍升高。结论VAP的病原菌在老年患者中以革兰阴性菌占优势,鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、嗜麦芽寡养单胞菌、金黄色葡萄球菌为VAP的主要致病菌,真菌感染的发生率不可忽视,临床上应加强抗菌药物的合理使用。OBJECTIVE To examine the categories of geriatric ventilator-associated pneumonia（VAP） pathogens and their drug-resistance so as to provide evidence for clinical rational use of antibiotics.METHODS 161 geriatric inpatients receiving ventilator respiration treatment were targetedly monitored.The microbial sensitivity tests and antibiotic test results were retrospectively analyzed.RESULTS 215 pathogens were isolated from 82 geriatric patients,of which Gram-negative bacteria occupying 73.95%,Gram-positive bacteria occupying 15.81%,and fungi occupying 10.23%.In Gram-negative bacteria isolates,Acinetobacter baumannii（20.47%） were the most commonly identified,followed by Pseudomonas aeruginosa（19.53%）,Klebsiella pneumoniae（14.88%） and Stenotrophomona maltophilia（13.95%）,and in Gram-positive bacteria,Staphylococus aureus（8.84%） were the most commonly identified.Oidiomycetes were the major pathogens for fungi infections.The antibiotic resistance of the pathogens were increasingly higher.CONCLUSIONS In VAP pathogenic isolates,Gram-negative bacteria are most common.The most common VAP isolates in geriatric patiants are A.baumannii,P.aeruginosa,K.pneumoniae,S.maltophilia and S.aureus and the incidence of fungi infection can not be ignored which requied a rational clinical use of antibiotics.

关 键 词：老年患者 呼吸机相关性肺炎 病原菌 耐药 

分 类 号：R378[医药卫生—病原生物学]