老年糖尿病合并肺部感染84例病原菌及其耐药性分析  

Analysis on pathogenic bacteria and drug resistance of 84 patients with elderly diabetes and pulmonary infection

作　　者：林允信[1] 李陕区[2] 杨博[2] 王伯良[3] 

机构地区：[1]解放军兰州军区兰州总医院安宁分院康复科,甘肃兰州730070 [2]解放军第四军医大学唐都医院门诊科,陕西西安710038 [3]解放军第四军医大学唐都医院急诊科,陕西西安710038

出　　处：《临床军医杂志》2012年第1期130-132,共3页Clinical Journal of Medical Officers

摘　　要：目的了解老年糖尿病合并肺部感染的病原菌及其耐药性并讨论其临床意义。方法回顾性分析84例老年糖尿病合并肺部感染患者病原菌和耐药性的临床资料。结果共送痰培养检测136次,培养出病原菌122株,其中细菌94株,真菌28株;革兰阴性菌62株(60.0%),革兰阳性菌32株(34.0%)。老年糖尿病合并肺部感染中有28例的经验性治疗与药敏结果相吻合,控制感染困难的38例最终根据痰培养结果更换抗菌药或联用抗菌药,大多数感染得到有效控制;耐药明显的有12例,因感染控制失败最终死亡,住院病死率为14.3%。结论老年糖尿病患者合并肺部感染的病原菌多为革兰阴性茵,对常用抗生素耐药明显。抗生素的合理使用,是控制药物滥用引起细菌耐药性的关键。Objective To investigate the pathogenic bacteria and drug resistance in patients with elderly diabetes and pulmonary infection and its clinical significance.Methods A retrospective review was adopted to analyze the clinical data of 84 patients with elderly diabetes and pulmonary infection.Results One hundred twenty-two strains of pathogenic bacteria were found in 136 samples of sputum culture,including 94 strains of bacteria（66.0% Gram-negative bacteria and 34.0% Gram-positive bacteria） and 28 strains of fungus.During 84 patients with elderly diabetes and pulmonary infection,of 28 cases were a drug sensitivity in good agreement with empirical treatment,38 cases of poor infection control,according to sputum culture or in combination with antibiotics after the replacement of the majority of infections under control,there were 12 cases of apparent drug resistance,infection can not control the final hospital mortality was 14.3%.Conclusion The patients with elderly diabetes and pulmonary infection were mainly due to Gram-negative bacteria,which were resistant to common antibiotics.Clinicians should do more sputum cultures and rationally use antibiotics to avoid refractoriness infection induced by multiple drug resistance.

关 键 词：老年 糖尿病 肺部感染 病原菌 多药耐药性 

分 类 号：R587.1[医药卫生—内分泌]