老年患者下呼吸道感染病原菌分布及耐药性分析  

Pathogenic bacteria distribution and drug resistance analysis for elderly patients with lower respiratory tract infections

作　　者：刘琰[1] 马文浩[2] 赵鑫亮[1] 

机构地区：[1]齐齐哈尔医学院附属第三医院呼吸一科,黑龙江齐齐哈尔161000 [2]齐齐哈尔市第一医院口腔科,黑龙江齐齐哈尔161000

出　　处：《中华医院感染学杂志》2014年第16期3922-3924,共3页Chinese Journal of Nosocomiology

基　　金：黑龙江省科技厅基金资助项目(SFZD-2012088)

摘　　要：目的探讨老年患者下呼吸道感染病原菌的分布及其耐药性,为指导临床合理用药提供参考依据。方法选取2010年4月-2013年7月老年下呼吸道感染患者480例,采集所有患者痰液及支气管灌洗液标本进行病原菌检测,菌种鉴定采用法国生物梅里埃公司VITEK-60全自动细菌分析仪,药物敏感试验采用K-B纸片扩散法。结果 480例老年下呼吸道感染患者检出病原菌790株,其中革兰阴性菌463株占58.61%,革兰阳性菌259株占32.78%,真菌有68株占8.61%;革兰阴性菌对于喹诺酮类、氨基糖苷类、第三代头孢菌素等抗菌物耐药率较高,其中耐药率较高的是亚胺培南、头孢哌酮/舒巴坦、哌拉西林/唑巴坦,约100.00%;革兰阳性菌对克林霉素、左氧氟沙星、红霉素、青霉素有较高的耐药性;真菌的耐药率普遍较低。结论老年患者下呼吸道感染病原菌主要以革兰阴性菌为主,加强对病原菌分布以及耐药性监测,根据监测结果合理使用抗菌药物,以减少新耐药菌株的形成,降低医院感染的发生。OBJECTIVE To discuss pathogenic bacteria distribution and drug resistance analysis for elderly patients with lower respiratory infections,so as to guide clinical rational drug use.METHODS Apr.2010 to Jul.2013,pneumococcal infections in elderly patients 480 patients were collected in all patients sputum and bronchial ravage specimens for pathogen detection,strain identification using French bioMérieux VITEK-60 automatic bacteria analyzer,drug susceptibility testing methods used were K-B disk diffusion method.RESULTS A total of 790 strains of pathogen were detected among 480 cases of elderly patients with lower respiratory infections,among which 463gram-negative bacteria accounted for 58.61%,259gram-positive bacteria accounted for 32.78%,68 fungi accounted for 8.61%;gram-negative bacteria had high resistance rates to guinolones,amino glycosides,third-generation cephalosporin,cefoperazone/sulfate,piperacillin amoxicillin/tazobactam,close to 100.00%;gram-positive cocci had high resistance rates to clindamycin,levofloxacin,erythromycin,penicillin;fungal resistance rate was generally low.CONCLUSION Elderly patients major pathogens art gram-negative bacteria.Monitoring for distribution and drug resistance of pathogens should be strengthened.According to monitoring results,be reasonable clinical use of antimicrobial drugs should be taken,thereby reducing the formation of new resistant strains to reduce hospital infections.

关 键 词：老年患者 下呼吸道感染 临床分布 耐药性 

分 类 号：R378[医药卫生—病原生物学]