高龄患者医院获得性肺部感染的病原菌分布和药物敏感性研究  

Pathogenic bacteria distribution and drug sensitivity of hospital acquired pulmonary infections in elderly patients

作　　者：王灿灿[1] 冯月娟[1] 黄旭晴[1] 郁东伟[1] 

机构地区：[1]杭州师范大学附属医院呼吸科,浙江杭州310013

出　　处：《全科医学临床与教育》2017年第5期509-511,共3页Clinical Education of General Practice

基　　金：浙江省公益性技术应用研究计划项目(2015C33258)

摘　　要：目的探讨医院获得性肺部感染高龄患者的病原菌分布情况,并进行药物敏感性实验,分析相关的耐药情况。方法纳入291例医院获得性肺炎高龄患者进行研究,收集痰标本进行病原菌分布情况检测,并进行药物敏感性实验,分析其对不同抗菌药物的耐药性。结果 291例患者的痰标本共分离出441株病原菌,其中真菌数量最少,共30株,革兰阴性细菌数量最多,共270株,占全部病原菌数量的61.22%。金黄色葡萄球菌、溶血性葡萄球菌、粪肠球菌等革兰氏阳性菌相关的敏感药物包括利奈唑胺、替考拉宁和万古霉素,对庆大霉素、头孢唑啉以及青霉素等药物则表现出不同程度的耐药情况。大肠埃希氏菌、肺炎克雷伯菌、铜绿假单胞菌以及鲍曼不动杆菌等革兰氏阴性菌相关的敏感药物主要为碳青酶烯类药物美罗培南,对氨苄西林则表现出较为明显的耐药现象。结论革兰阴性细菌是导致医院获得性肺部感染高龄患者肺部感染的主要病原菌,不同病原菌对不同的药物耐药性不同,临床治疗中应合理选用抗菌药物。Objective To investigate the pathogenic bacteria distribution in elderly patients with hospital acquired pulmonary infection and analyze the drug resistance by the drug sensitivity test. Methods Totally 291 elderly patients with hospital acquired pneumonia were enrolled. The sputum samples were collected to examine the distribution of pathogens,and drug sensitivity tests were conducted to analyze the resistance to different antimicrobial agents. Results A total of 441 strains of pathogenic bacteria were isolated from the sputum samples of 291 patients,including the fungi with 30 strains that was the fewest,the gram negative bacteria with 270 strains was the most,which accounting for 61.22% of the total number of pathogenic bacteria. The sensitive drugs for staphylococcus aureus and hemolytic staphylococcus,enterococcus faecalis and other gram positive bacteria were the linezolid,teicoplanin and vancomycin,while showed different degrees of resistance to gentamicin,cefazolin and penicillin. The sensitive drugs for escherichia coli,klebsiella pneumoniae,pseudomonas aeruginosa and acinetobacter baumannii and other gram negative bacteria were carbopenems meropenem,while showed obvious phenomena of resistance to ampicillin. Conclusion Gram negative bacteria are the main pathogens causing pulmonary infection in elderly patients with hospital acquired pulmonary infection. Different pathogens have different resistance to drugs,and antibiotics should be used rationally in clinical treatment.

关 键 词：医院获得性肺部感染 高龄患者 病原菌 药物敏感性 

分 类 号：R563.1[医药卫生—呼吸系统]