老年患者感染病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens causing infections in elderly patients

作　　者：吴明德[1] 叶霞[1] 邹艳[1] 王祎[2] 蒋新文[1] 

机构地区：[1]自贡市第五人民医院检验科,四川自贡643020 [2]自贡市第五人民医院特检科,四川自贡643020

出　　处：《中华医院感染学杂志》2014年第20期5005-5007,共3页Chinese Journal of Nosocomiology

基　　金：四川省卫生厅科研基金资助项目(130516)

摘　　要：目的了解老年患者感染病原菌分布及耐药性,为老年患者感染的控制和抗菌药物选择提供参考依据。方法收集2011年1月-2012年12月发生感染的773例老年患者临床标本,按照《全国临床检验操作规程》对合格标本进行接种、培养、分离、鉴定与药敏试验,所有数据采用SPSS13.0软件进行统计分析。结果 773例老年患者主要感染部位为下呼吸道393例、泌尿道138例、上呼吸道106例,分别占50.8%、17.9%、13.7%;培养出病原菌508株,以肺炎克雷伯菌、铜绿假单胞菌、鲍氏不动杆菌、表皮葡萄球菌、大肠埃希菌和金黄色葡萄球菌为主,分别占25.8%、18.1%、11.6%、11.6%、5.9%和5.3%;125株革兰阳性菌对青霉素、氨苄西林、红霉素、环丙沙星及磺胺甲噁唑/甲氧苄啶的耐药率较高,分别为92%、86.4%、84.8%、81.6%和75.2%,对亚胺培南、万古霉素、利福平和四环素的耐药率较低,分别为0.8%、8.0%、13.6%及19.2%,369株革兰阴性菌对氨苄西林、哌拉西林、磺胺甲噁唑/甲氧苄啶、头孢唑林及头孢他啶的耐药率较高,分别为97.3%、88.6%、83.7%、81.0%和50.9%,对亚胺培南、阿米卡星耐药率较低,分别为0.5%和5.4%。结论老年患者感染病原菌耐药率高,且多为多药耐药,除亚胺培南外,革兰阳性球菌对万古霉素、利福平和四环素敏感、革兰阴性菌对阿米卡星敏感,应根据药敏试验结果合理选用敏感抗菌药物,有效控制老年患者感染。OBJECTIVE To study the pathogen distribution and drug resistance of elderly patients with infections so as to provide a reference to the choice of infection control and antimicrobial drugs for the elderly patients . METHODS The clinical specimens of 773 cases of elderly patients with infections were collected from Jan 2011 to Dec 2012 .The qualified specimens were conducted ,inoculated ,cultivated ,isolated ,and identified ,and the drug susceptibility testing was performed according to the national clinical test procedures .All the data were analyzed statistically by the SPSS13 .0 software .RESULTS The top primary infection site of 773 elderly patients were the lower respiratory tract 393 cases ,accounting for 50 .8% ;urinary tract 138 cases ,accounting for 17 .9% ;upper respiratory tract 106 cases ,accounting for 13 .7% ;508 strains pathogenic bacteria were produced ,primarily were Klebsiellapneumoniae ,Pseudomonasaeruginosa,Acinetobacterbaumannii ,Staphylococcusepidermidis ,Esche-richia coli and Staphylococcus aureus , accounted for 25 .8% , 18 .1% , 11 .6% , 11 .6% , 5 .9% , 5 .3%respectively . The resistance rates of 125 gram-positive bacteria to penicillin , ampenicillin , erythromycin , ciprofloxacin and cotrimoxazole were 92% ,86 .4% ,84 .8% ,81 .6% and 75 .2% respectively .The resistance rates to lmipenem ,vancomycin ,rifampicin and tetracycline were 0 .8% ,8 .0% ,13 .6% and 19 .2% respectively . The resistance rate of 369 gram-negative bacteria to ampicillin ,the paila west morpholine ,cotrimoxazole ,the first cell oxazolin and the first cell betahistine were 97 .3% ,88 .6% ,83 .7% ,81 .0% and 50 .9% respectively .The resistance rates to imipenem and amikacin were 1 .5% and 5 .4% ,respectively .CONCLUSION The resistance rate of elderly patients infected with pathogen is high and most are multi-drug resistant .Besides imipenem ,gram-positive cocci are sensitive to vancomycin , rifampicin and tetracycline and gram-negative bacteria sensitive to amikacin .We should use sensitive antimicrobial agents reasona

关 键 词：老年患者 感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]