门诊老年患者呼吸道感染病原菌分布与影响因素分析  

Distribution of pathogens causing respiratory tract infections in elderly patients of outpatient department and influencing factors

作　　者：李芸[1] 胡国仙[1] 周华[1] 洪哲云[2] 卢彩霞[3] 

机构地区：[1]杭州市第一人民医院综合保健门诊,浙江杭州310006 [2]杭州市第一人民医院呼吸科,浙江杭州310006 [3]杭州市第一人民医院综合病房,浙江杭州310006

出　　处：《中华医院感染学杂志》2016年第2期314-316,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科学基金资助项目(2004A018)

摘　　要：目的探讨门诊老年患者呼吸道感染的病原菌类型及耐药性,分析呼吸道感染相关危险因素,为降低门诊老年患者呼吸道感染提供参考依据。方法回顾性分析医院2012年1月-2014年12月650例老年患者的临床资料,分析其感染病原菌类型、主要病原菌耐药性,并对呼吸道感染危险因素进行单因素和多因素方差分析,采用SPSS19.0软件对数据进行统计分析。结果 650例门诊老年患者发生呼吸道感染30例,感染率为4.62%,共检出病原菌42株,其中革兰阳性菌28株占66.67%,革兰阴性菌13株占30.95%,真菌1株占2.38%;革兰阴性菌以大肠埃希菌及铜绿假单胞菌为主,对亚胺培南、万古霉素耐药率较低,革兰阳性菌以表皮葡萄球菌及金黄色葡萄球菌为主,对万古霉素的耐药率较低;经单因素和logistic回归分析发现,年龄>70岁、未服保健品、合并糖尿病等因素是老年患者发生呼吸道感染的独立危险因素(P<0.05)。结论门诊老年患者呼吸道感染相关危险因素较多,应针对危险因素采取相应的措施进行干预。OBJECTIVE To explore the distribution and drug resistance of pathogens causing respiratory tract infections in elderly patients of outpatient department and analyze the related risk factors for the respiratory tract infections so as to provide guidance for reduction of incidence of the respiratory tract infections in the elderly patients.METHODS The clinical data of 650 elderly patients who were treated in the hospital from Jan 2012 to Dec 2014 were retrospectively analyzed,the distribution of the pathogens causing the infections and the drug resistance of the major pathogens were observed,the univariate analysis and multivariate analysis of variance were carried out for the risk factors for the respiratory tract infections,and the statistical analysis of data was performed with the use of SPSS19.0software.RESULTS Of 650 elderly patients of outpatient department,30 had respiratory tract infections with the infection rate of 4.62%.A total of 42 strains of pathogens were isolated,including 28（66.67%）strains of gram-positive bacteria,13（30.95%）strains of gram-negative bacteria,and 1（2.38%）strain of fungus.The Escherichia coli and Pseudomonas aeruginosa were dominant among the gram-negative bacteria,and the drug resistance rates to imipenem and vancomycin were low.The Staphylococcus epidermidis and Staphylococcus aureus were the predominant species of gram-positive bacteria,and the drug resistance rate to vancomycin was low.The univariate analysis and logistic regression analysis indicated that the more than 70 years of age,administration of health products,and complication of diabetic mellitus were the independent risk factors for the respiratory tract infections in the elderly patients（P〈0.05）.CONCLUSION There are a variety of risk factors for the respiratory tract infections in the elderly patients of outpatient department.It is necessary to take targeted intervention measures aiming at the risk factors.

关 键 词：呼吸道感染 病原菌 危险因素 门诊 

分 类 号：R378[医药卫生—病原生物学]