老年支气管扩张合并急性感染的病原菌及其耐药性研究  

Pathogens and drug resistant rate analysis of aged of bronchiectasis patients in an acute exacerbation

作　　者：宋秀杰[1] 路聪哲[1] 方庭正[1] 韩文杰[1] 芮萌[1] 欧敏[1] 

机构地区：[1]海军总医院干部呼吸科,北京100048

出　　处：《中国临床药理学与治疗学》2012年第8期914-918,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:了解老年支气管扩张患者急性感染的病原学分布及药敏情况,指导临床抗菌药物的使用。方法:对2000—2012年本院呼吸科104份老年支气管扩张急性感染患者的痰标本进行细菌培养及药敏试验。结果:150例痰标本分离出致病菌107株,其中革兰氏阴性菌87株,占81%,排在前3位的致病菌分别是铜绿假单胞菌(35%),肺炎克雷伯菌(14%),鲍曼不动杆菌(11%)。革兰氏阳性球菌8株(7%),真菌12株(11%)。药敏实验显示所分离出的革兰氏阴性杆菌对哌拉西林-他唑巴坦,第3、4代头孢菌素及碳青霉烯类、多粘菌素等抗菌药物敏感性较高。结论:老年支气管扩张急性感染的病原菌分布以革兰氏阴性杆菌为主,铜绿假单胞菌排在首位,经验治疗时建议选用哌拉西林/他唑巴坦、头孢三代、四代或碳青霉烯类药物。AIM： To learn the situation of pathogens distribution and drug sensitivity in aged bronchiectasis in an acute exacerbation. METHODS： 150 samples of sputum bacteria culture and drug sensitivity tests from 104 aged patients were performed in our hospital from 2000 to 2012. RESULTS. 107 isolates isolated from 150 sputum samples, among them there were 87 isolates of gram-negative bacillus （81%）. The most common Gram-negative bacillus isolated were Pseudomonas aeruginosa （35 %）, Klebsiella pneumoniae （14%）, Acinetobacter baumannii （11%）. There were 8 strains of gram-positive bacteria（7%）,12 strains of fungi（11%）. Piperacillin/tabazotani, three generation cephalo-sporin , four generation cephalosporin carbapenem ,and quinolone has better antimicrobial activity against, gram-negative bacillus. CONCLUSION： The main pathogen of aged bronchiectasis in an acute exacerbation was gram negative bacteria, pseudomonas aeruginosa was the most commen pathogens among them. Piperacillin/ tabazotani, three generation cephalosporin, four generation cephalosporin, carbapenem should be recommended to treat these aged bronchiectasis patients.

关 键 词：老年支气管扩张 急性加重 病原菌 药敏实验 

分 类 号：R269.574[医药卫生—中西医结合]