老年支气管扩张患者病原菌的分离鉴定及其耐药性调查  

In elderly patients with bronchiectasis pathogen isolation and identification of drug resistance

作　　者：刘振丽[1] 隋小芳[2] 刘艳[1] 胡依粉 

机构地区：[1]济宁医学院附属医院呼吸内科,272100 [2]佳木斯大学附属第一医院老年病科,154002

出　　处：《中国老年保健医学》2015年第3期9-13,共5页Chinese Journal of Geriatric Care

摘　　要：目的调查老年人支气管扩张患者中病原菌的分布及其耐药性的现状,为临床治疗提供参考依据。方法对329例老年支气管扩张患者的痰液病原菌分离鉴定和药物敏感性试验进行回顾性调查。结果 329例患者242例呈病原菌感染阳性,阳性率为73.56%。共分离出致病菌431株,其中鉴定出20种病原菌,以革兰氏阴性菌为主,占73.78%(318株),革兰氏阳性菌和真菌分别为57株(13.23%)和56株(12.99%)。革兰氏阴性菌主要为肺炎克雷伯杆菌和铜绿假单胞菌。革兰氏阴性菌中分离率较高的肺炎克雷伯杆菌、铜绿假单胞菌、大肠杆菌、嗜麦芽假单胞菌、鲍曼不动杆菌、流感嗜血杆菌和副流感嗜血杆菌对亚胺培南和美罗培南的敏感性较高,对其余抗菌药物都表现出一定的耐药率。革兰氏阳性菌对青霉素、阿莫西林、阿奇霉素、克林霉素、复方新诺明和环丙沙星表现出较高的耐药率,而对利福平、四环素、替考拉宁、万古霉素和利奈唑胺具有较高的敏感性。结论老年支气管扩张患者病原菌以革兰氏阴性菌为主,且病原菌耐药率高,因此临床使用抗菌药物治疗,应针对患者的病原菌的分布及其耐药性的特征进行。Objectives Survey of the elderly patients with bronchiectasis pathogenic bacteria distribution and drug resistance sit-uation, provide reference for clinical treatment.Methods In 329 cases of elderly patients with bronchiectasis pathogens isolated from sputum and drug sensitivity test were retrospectively investigation.Results 329 patients, 242 cases of pathogenic bacteria in-fection is positive, positive rate was 73.56%.A total of 431 strains pathogenic bacteria isolated, identified 20 kinds of pathogenic bacteria, mainly gram-negative bacteria, 73.78% （ 318 strains ） , gram positive bacteria and fungi, respectively 57 strains （13.23%） and 56 strains （12.99%）.Gram-negative bacteria are mainly with klebsiella pneumoniae and pseudomonas aerugino-sa.High separation rate of gram-negative bacteria with klebsiella pneumoniae, pseudomonas aeruginosa, escherichia coli, eosinophil-ic malt pseudomonas, acinetobacter baumannii, haemophilus influenzae and the imine with haemophilus culture of the south and e-faecalis sensitivity high, show a certain percentages of antibacterial drugs for the rest.Gram positive bacteria to penicillin, amoxicil-lin, azithromycin and clindamycin, compound ciprofloxacin new Ming and showed high resistance, and to rifampin, tetracycline, teicoplanin, vancomycin and rina thiazole amine has higher sensitivity.Conclusions In elderly patients with bronchiectasis patho-gen is given priority to with gram-negative bacteria, high prevalence and pathogen resistance, which should be clinically rational use of antimicrobial agents.

关 键 词：支气管扩张 老年人 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]