老年肺炎患者病原菌分布与耐药性分析  

Distribution of pathogens causing pneumonia in senile patients and drug resistance

作　　者：刘祖德[1] 吕娟丽[1] 周广军[2] 崔佳[3] 刘鹰[1] 

机构地区：[1]武警总医院药剂科,北京100039 [2]武警总医院检验科,北京100039 [3]武警总医院中心实验室,北京100039

出　　处：《中华医院感染学杂志》2011年第2期398-400,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨老年肺炎患者病原菌的菌群分布及耐药情况,为临床合理用药提供依据。方法回顾性调查医院2007年9月-2009年9月146例老年肺炎患者的临床资料,分析病原菌分布特征及抗菌药物的耐药性。结果共收集病原菌163株,其中革兰阴性菌98株,占60.12%,革兰阳性菌41株,占25.15%,真菌24株,占14.73%;革兰阴性菌中以铜绿假单胞菌检出率最高,为14.72%,其次肺炎克雷伯菌、大肠埃希菌,检出率分别为12.88%、11.04%,革兰阴性菌对亚胺培南/西司他丁、阿米卡星、头孢吡肟的敏感性较高,而对氧氟沙星、环丙沙星、磺胺甲噁唑/甲氧苄啶的耐药率均>50.00%,革兰阳性菌以金黄色葡萄球菌最多见,占9.82%,其次为肠球菌属,占6.75%;革兰阳性菌对头孢唑林、头孢噻肟、环丙沙星的耐药率均>60.00%,而对万古霉素、替考拉宁完全敏感。结论老年肺炎患者以革兰阴性杆菌为优势菌株,且耐药性日趋严重,对亚胺培南/西司他丁、阿米卡星、头孢吡肟敏感性较高,革兰阳性球菌感染宜以万古霉素为首选。OBJECTIVE To study the distribution and drug resistance of pathogens causing pneumonia in senile patients,so as to provide basis for reasonable application of antibiotics.METHODS The clinical data of 146 senile pneumonia patients in our hospital from Sep 2007 to Sep 2009 were reviewed.The pathogen types and antibiotic sensitivity of pathogens isolated from cultured sputum collected from the patients were analyzed.RESULTS A total of 163 strains,including 98 strains of Gram-negative bacteria（60.12%）,41strains of Gram-positive bacteria（25.15%）,24 strains of fungi（14.72%）,were collected.The detection rates of Pseudomonas aeruginosa（14.72%）,Klebsiella pneumonia（12.88%） and Encherichia coli（11.04%） were the main microorganisms.The effective agents against Gram-negative bacteria were imipenem,amikacin and cefepime,while the drug resistance rates of Gram-negative bacteria to ofloxacin,ciprofloxacin and co-trimoxazole were above 50.0%,Staphylococcus aureus was the most common Gram-positive bacteria,accounting for 9.82%,the following was Enterococcus,accounting for 6.75%.The drug resistance rates of Gram-positive bacteria to cefazolin,penicilin and ciprofloxacin were almost above 60.00% while most Gram-positive bacteria were sensitive to vancomycin and teicoplanin.CONCLUSION The drug resistance of bacteria in senile pneumonia patients is increasing.Gram-negative bacteria are the dominant pathogens causing pneumonia in senile patients,the drug resistance is increasing and the susceptibility to imipenem,amikacin and cefepime are high,while vancomycin is the preferred antibiotic to treat the Gram-positive cocuus infection.

关 键 词：老年肺炎患者 抗菌药物 药敏试验 

分 类 号：R378[医药卫生—病原生物学]