老年慢性精神分裂症患者肺部感染的病原学分析  

Etiology analysis of lung infections in elderly patients with chronic schizophrenia

作　　者：陈正昕[1] 陈炯[1] 金卫东[1] 

机构地区：[1]浙江省立同德医院精神科,浙江杭州310012

出　　处：《中华医院感染学杂志》2015年第7期1562-1564,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技基金资助项目(2006A017)

摘　　要：目的探讨老年慢性精神分裂症患者肺部感染的常见病原菌分布及抗菌药物治疗敏感性,提高对老年慢性精神分裂症患者医院感染的认识,降低感染率。方法选取2009年3月-2013年12月老年慢性精神分裂症发生肺部感染的患者137例,取患者痰液标本进行病原菌培养和药物敏感试验,对结果进行统计,采用SPSS17.0软件进行统计分析。结果 137例肺部感染患者共检出病原菌109株,检出率为79.56%;以革兰阴性菌为主,共76株占69.72%;革兰阴性菌对头孢哌酮/舒巴坦以及亚胺培南表现出了极高的药物敏感性,均达到93.42%,革兰阳性菌对替考拉宁以及万古霉素敏感,而对青霉素和磺胺甲噁唑/甲氧苄啶的敏感性较低,仅有6.25%和9.38%。结论导致老年慢性精神分裂症患者肺部感染的病原菌种类繁多、种类不同,对抗菌药物的敏感性也不同,在确诊之后可以首先给予经验性联合用药,对肺部感染进行控制;而在经验性用药之前,及时进行痰液培养及药敏试验,以便根据病原菌进行针对性的治疗,保证治疗效果。OBJECTIVE To investigate the distribution of common pathogens infected by the lungs of elderly patients with chronic schizophrenia and sensitivity of antibiotics,so as to improve the awareness of nosocomial infections in elderly patients with chronic schizophrenia and to decrease the infection rate.METHODS Totally 137 cases of pulmonary infected elderly patients with chronic schizophrenia from Mar.2009 to Dec.2013 were selected and their sputum samples were cultivated and drug sensitive test were conducted.The results were statistically analyzed by SPSS 17.0software.RESULTS Among the 137 cases,109strains of pathogenic bacteria were detected.The detection rate was 79.56%.Gram-positive bacteria dominated the majority and accounted for 76strains（69.72%）.The gram-negative bacteria were highly sensitive to cefoperazone/sulbactam and imipenem.The sensitive rate reached 93.42%.The gram-positive bacteria were sensitive to teicoplanin and vancomycin while insensitive to penicillin and sulfamethoxazole/trimethoprim with the sensitive rate of only 6.25% and 9.38%.CONCLUSIONThe pathogenic bacteria causing pulmonary infections in elderly patients with chronic schizophrenia are of a wide range and variety and they also own different sensitivity to various antibiotics.We can control the pulmonary infections by using combination therapy according to experience after the definite diagnosis.And before using the drugs,we should cultivate sputum and test the drug sensitivity in time so as to treat the patients according to characteristics of pathogens and guarantee the clinical effects.

关 键 词：精神分裂 医院感染 肺部感染 病原学 治疗 

分 类 号：R563.1[医药卫生—呼吸系统]