老年精神病患者呼吸道感染的病原菌分布与耐药性分析  

Distribution and drug resistance of pathogens causing respiratory tract infections in elderly patients with mental illness

作　　者：王新友[1] 王领军[2] 李艳丽[3] 杨世昌[1] 

机构地区：[1]新乡医学院第二附属医院精神二科,河南新乡453002 [2]新乡医学院第二附属医院临床药学部,河南新乡453002 [3]河南科技学院校医院,河南新乡453003

出　　处：《中华医院感染学杂志》2015年第13期2954-2956,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技攻关重点基金项目(0524420029)

摘　　要：目的探讨老年精神病患者呼吸道感染病原菌分布特点及耐药性分析,为合理使用抗菌药物提供依据。方法选择2012年1月-2013年12月320例老年精神病呼吸道感染住院患者,对其痰液使用法国生物梅里埃公司API鉴定系统进行培养鉴定及药敏分析。结果 320例患者培养出412株病原菌,革兰阴性菌248株占60.2%,其中肺炎克雷伯菌占16.7%、铜绿假单胞菌占15.5%、大肠埃希菌占12.1%;革兰阳性菌81株占19.7%,以金黄色葡萄球菌为主占10.2%,其中耐甲氧西林金黄色葡萄球菌(MRSA)检出率为71.4%;真菌83株占20.1%,以白色假丝酵母为主占10.9%;革兰阴性菌对亚胺培南和美罗培南高度敏感,耐药率均为0;未检出耐万古霉素金黄色葡萄球菌。结论老年精神病患者呼吸道感染主要为革兰阴性菌,真菌感染率具有不断升高趋势,临床上应对病原菌及药敏性加强监测,并选择合理的抗菌药物。OBJECTIVE To explore the distribution and drug resistance of the pathogens causing respiratory tract infections in the elderly psychiatric patients so as to provide guidance for reasonable use of antibiotics .METHODS A total of 320 elderly psychiatric patients with respiratory tract infections who were hospitalized from Jan 2012 to Dec 2013 were enrolled in the study ,then the sputum specimens were cultured and identified by using API identifi‐cation system of BioMerieux ,France ,and the drug susceptibility testing was performed .RESULTS Totally 412 strains of pathogens have been cultured from the 320 patients ,including 248 （60 .2% ） strains of gram‐negative bacteria ,81 （19 .7% ） strains of gram‐positive bacteria ,and 83 （20 .1% ） strains of fungi .Among the gram‐nega‐tive bacteria ,the K lebsiella pneumoniae , Pseudomonas aeruginosa ,and Escherichia coli accounted for 16 .7% , 15 .5% ,and 12 .1% ,respectively ;the Staphylococcus aureus was the predominant species of the gram‐positive bacteria ,accounting for 10 .2% ,and the isolation rate of the methicillin‐resistant S .aureus （MRSA） was 71 .4% ;the Candida albicans was dominant among the fungi ,accounting for 10 .9% .The gram‐negative bacteria were highly susceptible to imipenem and meropenem ,with the drug resistance rate of 0;no strain of vancomycin‐resist‐ant S .aureus was found .CONCLUSION The gram‐negative bacteria are dominant among the pathogens causing the respiratory tract infections in the elderly psychiatric patients ,and the incidence of fungal infections shows an up‐ward trend .It is necessary for the hospital to strengthen the surveillance of the pathogens and the drug susceptibil‐ity so as to reasonably use antibiotics .

关 键 词：老年精神病患者 呼吸道感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]