老年住院患者临床分离细菌的分布及耐药性  

The distribution and drug resistance of clinical bacterial strains from elder inpatients

作　　者：方毅[1] 庞立峰[1] 涂婉[1] 阚蔚利[1] 赵虎[1] 

机构地区：[1]复旦大学附属华东医院检验科,上海200040

出　　处：《检验医学》2011年第6期398-401,共4页Laboratory Medicine

摘　　要：目的了解华东医院老年住院患者的病原菌分布和耐药性变迁情况,以及与患者的年龄、基础疾病、标本来源的关系。方法连续监测华东医院近2年老年患者感染的病原菌的分布和耐药性的变迁。从60岁以上老年患者临床标本(痰、血、尿、胆汁、伤口等)中分离病原菌1 266株,其中革兰阴性菌945株,革兰阳性菌321株,对菌株进行鉴定和药敏分析。临床收集患者年龄、基础疾病、感染症状等相关资料,进行统计分析。结果以大肠埃希菌、铜绿假单胞菌和金黄色葡萄球菌感染率最高;心血管疾病和呼吸系统疾病患者以铜绿假单胞菌感染率最高;痰标本、尿标本、伤口及胆汁等以铜绿假单胞菌和大肠埃希菌感染率最高;铜绿假单胞菌对头孢类、碳青霉烯类、喹诺酮类和氨基糖苷类药物耐药率最高,金黄色葡萄球菌对左氧氟沙星和青霉素的耐药率最高,而常见革兰阳性球菌对万古霉素和利奈唑胺均敏感。结论细菌耐药性乃呈上升趋势,加强对耐药菌的检测和耐药机制以及其与基础疾病关系的研究,对老年人群正确选用抗菌药物和控制耐药菌的感染非常重要。Objective To understand the distribution of pathogens and their resistance to antibiotics in elder inpatients of Huadong Hospital, as well as the relationship between the patients＇ age, the underlying diseases and the type of specimen resource. Methods The distribution of pathogens in elder inpatients and the change of drug resistance were monitored continuously during the past 2 years. 1 266 strains, including 945 Gram negative strains and 321 Gram positive strains, were isolated from clinical specimens （ sputmn, blood, urine, bile and wound, etc. ） of patients aged above 60 years. All identifications and susceptibilities were determined. The relevant information including patient＇s age, underlying diseases, signs and symptoms pertaining to different infections was collected for statistical analysis. Results Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus were the most common pathogens in the elder inpatients. The prevalence of Pseuclomonas aeruginosa was the highest in respiratory system diseases and cardiovascular diseases. The prevalences of Pseudomonas aeruginosa and Escherichia coli were the highest in sputum, urine, wound and bile, etc. The resistance rate of Pseudomonas aeruginosa to cephalosporins, carbapenems, quinolones and aminoglycosides was the highest. The resistance rate of Staphylococcus aureus to levofloxacin and penicillin was the highest. Nevertheless, the resistance rate to vancomycin and linezolid in common Gram positive cocci was nearly zero. Conclusions Bacterial resistance is found to be increasing. It should emphasize on monitoring the relationship of underlying diseases with resistance and resistance mechanism, and it is important to choose the appropriate antibiotics to control infections.

关 键 词：耐药性 细菌分布 基础疾病 老年住院患者 

分 类 号：R446.5[医药卫生—诊断学]