老年获得性肺炎病原菌及耐药分析  

ANALYSIS OF PATHOGENS AND RESISTANCE TO DRUGS ON GERIATRIC NOSOCOMIAL PNEUMONIA

作　　者：徐红云[1] 韦丽华[1] 刘春林[1] 江河[1] 

机构地区：[1]云南省第二人民医院,昆明650021

出　　处：《中国微生态学杂志》2002年第5期285-286,共2页Chinese Journal of Microecology

摘　　要：目的 :了解老年人获得性肺炎的病原菌及耐药趋势。方法 :对本院 1999年 6月～ 2 0 0 1年 6月两年间老年性获得性肺炎患者的痰标本进行细菌学分离鉴定及耐药分析。结果 :老年院内感染以 G-杆菌为主67.19% ,其次是真菌 2 2 .0 8及 G+球菌 10 .73 %。 G-杆菌中以大肠埃希菌 (2 9.12 % )、非发酵菌 (2 4.88% )和肺炎克雷伯菌 (2 0 .19% )为主 ,在大肠埃希菌和肺炎克雷伯菌中 ,产超广谱 β-内酰胺酶株 (ESBL S)占49.5 2 % ;真菌中以白色假丝酵母菌 (68.5 7% )为主 ;G+球菌中以凝固酶阴性葡萄球菌为主 (87.88% ) ,耐苯唑西林凝固酶阴性葡萄球菌 (MRSCN)占 63 .64 %。 2 0 0 0年 6月～ 2 0 0 1年 6月所分离的细菌与上一年相比 ,真菌由 15 .43 %增加到 2 9.0 3 % (P<0 .0 1) ,G+球菌由 6.17%增加到 15 .48% (P<0 .0 1) ,G-杆菌由78.4%下降到 5 5 .48% (P<0 .0 1)。所分离细菌除对亚胺培南、特治星 (哌拉西林 /他唑巴坦 )及万古霉素耐药率较低外 ,常用的抗生素显示较高的耐药率。结论 :老年性获得性肺炎以 G-杆菌为主 ,而真菌的感染也不容忽视 ;致病菌呈多重耐药趋势 ,其感染菌谱的变迁和多重耐药率的升高应该引起高度重视 。Objective:To know for the bacteria of geriatric nosocomial pneumonia and the change of drug resistance in inpatient.Method:The bacteria were isolated from sputum of geriatric nosocomial pneumonia and thier drug resistance were analysed during Jume 199～June 2001.Results:The most prevailing isolates of pathogens of geriatric nosocomial pnuemonia were Gram negative bateria (67 9%) then fungi (22 08%) and Grampositive bacteria (10 73%), Escherichia coli in Gram negative bacteria (29 12%),then Nonfermenters(24 88%) and Klebsiella pneumonia(14 4%),49 52% Extended spectrum β lactamase (ESBLs) were inspected in Escherichia coli and Klebsiella;Candida albicans(68 57%)was main type of fungi and Staphylococcus of coagulase negative(87 88%) was main germs in Gram positive bacteria,Among Staphylococcus of coagulase negative MRSCN were 63 64%.The percentage of fungi increased from 15 43%(in 2000)to 29 03%(in 2001),and Gram positive bacteria also increased from 6 17%(in 2000) to 15 48%(in 2001),But that Gram negative bacteria decreased from 78 4%(in 2000) to 55 48%(in 2001) All the isolated pathogens had high grud resistance rate for common antibitics except for emipenem?piperacillin/tazobactam and vancomycin.Conclusions:The main pathogens of geriatric nosocomial pneumonia was Gram negative bacteria,but fungi infection was evry important.The most isolated pathogens were multidrug resistance,Understanding the kinds of bacteria changing and bacteria resistance rate increasing were prerequisite of useing antibiontics rationally.

关 键 词：获得性肺炎 病原菌 耐药分析 老年人 

分 类 号：R563.1[医药卫生—呼吸系统]