老年菌血症患者感染病原菌分布与耐药性分析  

Distribution and drug resistance of pathogens in elderly patients with bactericidal infections

作　　者：田丹[1] 张宇[1] 熊亮[2] 

机构地区：[1]华中科技大学同济医学院附属普爱医院内科,湖北武汉430033 [2]华中科技大学同济医学院附属梨园医院检验科,湖北武汉430077

出　　处：《中华医院感染学杂志》2015年第13期2938-2940,共3页Chinese Journal of Nosocomiology

基　　金：湖北省卫生厅基金资助项目(WJ01567)

摘　　要：目的分析老年菌血症患者感染病原菌分布及耐药性,为临床合理用药提供指导依据。方法选取武汉市普爱医院和武汉市梨园医院2013年1-6月收治的181例老年菌血症患者为调查对象,采集血液样本进行细菌培养及药敏试验,并分析结果。结果采集249份血液标本细菌培养阳性,共检出病原菌181株,其中革兰阴性菌98株占54.1%,以大肠埃希菌和肺炎克雷伯菌为主,革兰阳性菌69株占38.1%,真菌14株占7.8%;主要革兰阴性菌对亚胺培南、阿米卡星、头孢西丁、阿莫西林、庆大霉素的耐药率较低,分别为2.4%、4.9%、17.1%、17.1%和18.7%,主要革兰阳性菌对万古霉素、替考拉宁、利奈唑胺的耐药率较低,分别为0、20.0%、20.0%,真菌对酮康唑、伊曲康唑、制霉菌素、两性霉素B均表现出较好的抗菌效果,耐药率分别为16.7%、13.3%、13.0%、1.3%。结论革兰阴性菌是导致老年菌血症的主要病原菌,抗菌药物的选用要基于药敏试验结果进行,避免抗菌药物的滥用。OBJECTIVE To analyze the distribution and drug resistance of pathogens in elderly patients with bacte‐remia so as to provide guidance for clinical rational drug use .METHODS Totally 181 elderly patients with bactere‐mia admitted and treated in Wuhan Pu＇ai Hospital and Wuhan Liyuan Hospital from Jan .to Jun .2013 were select‐ed as the research subjects .Blood samples were collected for bacterial culture and sensitivity test and the results were analyzed .RESULTS The 249 blood samples were tested as positive by bacterial culture and 181 pathogens were detected ,including 98 gram‐negative bacteria ,accounting for 54 .1% ,dominated by Escherichia coli and K lebsiella pneumonia;69 gram‐positive bacteria ,accounting for 38 .1% ;14 fungi ,accounting for 7 .8% .The drug resistance analysis showed that main gram‐negative bacteria had low resistance rates to imipenem ,amikacin , cefoxitin ,amoxicillin and gentamicin ,being 2 .4% ,4 .9% ,17 .1% ,17 .1% and 18 .7% .Main gram‐positive bac‐teria had low resistance rates to vancomycin ,teicoplanin and linezolid ,the resistance rates were 0 .0% ,20 .0%and 20 .0% ,respectively .For fungi ,ketoconazole ,itraconazole ,nystatin and amphotericin B exhibited good anti‐bacterial effect ,resistance rates were 16 .7% ,13 .3% and 1 .3% ,respectively .CONCLUSION Gram‐negative bac‐teria are the major cause of bacteremia in elderly patients ,the use of antimicrobial drugs should be based on sus‐ceptibility testing results so as to avoid overuse of antibiotics .

关 键 词：老年患者 菌血症 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]