2007-2012年老年患者医院感染调查与护理  

Nursing of nosocomial infections in senile patients from 2007 to 2012

作　　者：孙静意[1] 杨艳霞[1] 

机构地区：[1]天津市第一中心医院老干部科,天津300192

出　　处：《中华医院感染学杂志》2015年第7期1555-1557,共3页Chinese Journal of Nosocomiology

基　　金：天津市自然科学基金资助项目(13JCYBJC23400)

摘　　要：目的分析老年住院患者医院感染的流行病学及其耐药变迁,为临床治疗提供参考依据。方法收集2007年1月-2012年12月年龄>60岁住院患者临床分离菌株1 432株,采用微量稀释法进行药敏试验,采用SPSS17.0进行统计分析。结果临床分离菌株中呼吸道标本最多为1 034株占72.2%;细菌培养送检阳性率69.53%,高于全院的61.58%;革兰阳性菌311株占21.7%,革兰阴性菌1 121株占78.3%;耐甲氧西林金黄色葡萄球菌为31.8%,低于全院指标,产ESBLs大肠埃希菌为54.5%、产ESBLs肺炎克雷伯菌为46.7%,与全院指标相近;2007-2012年革兰阳性菌中葡萄球菌属和肠球菌属对抗菌药物的耐药性无明显变化;革兰阴性菌中肠杆菌科对碳青霉烯类保持高度敏感,其次为哌拉西林/他唑巴坦,而大肠埃希菌对头孢吡肟和头孢他啶的耐药率呈下降趋势。结论该项观察结果对于了解老年患者医院感染的流行病学特征、制定相应护理措施有一定的参考价值。OBJECTIVE To investigate the epidemiology and the changes in antibiotic resistance of isolates from hospitalized elderly patients so as to provide reference for clinical treatment.METHODS A total of 1 432 bacterial strains were isolated from elderly patients（≥60years old）from Jan.2007 to Dec.2012.Antimicrobial susceptibility testing was done by micro-dilution method.The software SPSS17.0 was used for statistical analysis.RESULTS Among the bacterial strains,most were from respiratory tract specimens（1 034 strains,72.2%）.The positive rate of bacterial culture was 69.53%in elderly patients,higher than that of the whole hospital（61.58%）.There were 311（21.7%）strains of gram-positive bacteria and 1 121（78.3%）strains of gram-negative bacteria.Methicillin resistant Staphylococcus aureus（MRSA）accounted for 31.8%,lower than the overall limit of the hospital.Detection rates of ESBLs-producing Escherichia coli and Klebsiella pneumoniae were 54.5% and46.7%,close to the overall limit of the hospital.The antimicrobial resistances of Staphylococcus and Enterococcus had no obvious changes in these years.The gram-positive Enterobacteriaceae strains showed high sensitivity to carbopenems,then to piperacillin/tazobactam.But the resistance rates of E.coli to cefepime and ceftazidime were decreasing gradually in the past years.CONCLUSIONThis observation is important and valuable for investigating epidemiology and making nursing measures in elderly patients.

关 键 词：老年患者 医院感染 护理 

分 类 号：R181.32[医药卫生—流行病学]