143例老年卒中相关性肺炎病原菌分析和耐药性监测  

Analysis of the distribution and drug resistance of pathogens in 143 elderly inpatients with stroke-associated pneumonia

作　　者：钱云[1] 程曦[1] 陆小伟[1] 陈伟贤[1] QIAN Yun CHENG Xi LU Xiao-wei CHEN Wei-xian.(Department of Geriatrics, the First Affiliated Hospital of Naniing Medical University. Nanjing 210029. China)

机构地区：[1]南京医科大学第一附属医院老年神经科,江苏省南京市210029

出　　处：《实用老年医学》2016年第12期1027-1029,共3页Practical Geriatrics

基　　金：国家自然科学基金青年科学基金(81100858)

摘　　要：目的探讨老年卒中相关性肺炎(stroke-associated pneumonia,SAP)患者肺部感染病原菌分布及耐药性监测情况。方法回顾性收集南京医科大学第一附属医院老年医学科近3年收治的老年SAP患者143例,进行病原菌分离、培养和药敏试验,并对药敏试验结果进行分析。结果从老年SAP患者痰标本中共分离出174株病原菌,其中革兰阴性菌占58.6%,主要是铜绿假单胞菌、肺炎克雷白菌、鲍曼不动菌等;革兰阳性菌占20.7%,主要是金黄色葡萄菌;真菌占20.7%,主要是白色念珠菌。革兰阴性菌对碳青霉烯类抗菌药物的敏感率最高,革兰阳性菌对万古霉素的敏感性较高。真菌耐药率很低。结论老年SAP患者肺部感染的主要致病菌为革兰阴性菌,其次为革兰阳性菌和真菌。病原菌对抗菌药物存在多重耐药性,临床应重视和加强患者的病原学检查,指导临床合理用药,降低患者的死亡率。Objective To explore the distribution and drug resistance of pathogens in elderly inpatients with strokeassociated pneumonia（ SAP）. Methods Clinical data of 143 elderly patients with SAP in the First Affiliated Hospital of Nanjing Medical University in the last three years were collected. Pathogens were isolated from sputum and underwent antimicrobial susceptibility test. The results of the test were retrospectively analyzed. Results Among 174 strains of pathogens isolated,gram-negative bacteria occupied 58. 6%,and the main strains of which were Pseudomonas aeruginosa,Klebsiella pneumoniae and Acinetobacter baumannii; Gram-positive bacteria occupied 20. 7%,and the main strain was Staphylococcus aureus; Fungi occupied 20. 7%,and the main strain was Candida albicans. The most sensitive drug for the gram-negative bacteria was antibiotic carbapenem. In addition,vacomycin was the most useful antibiotic for the grampositive bacteria. The drug resistance rate for the fungi was quite low. Conclusions The main pathogens of SAP in the elderly are gram-negative bacteria, followed by gram-positive bacteria and fungi. These pathogens show multi-drug resistance. Therefore,it is impressive to focus on the etiology examination to provide guidance for rational use of antibiotics so as to reduce the mortality of the patients.

关 键 词：老年人 卒中相关性肺炎 病原菌 耐药性 

分 类 号：R563.1[医药卫生—呼吸系统]