老年和中青年病人铜绿假单胞菌感染的临床分布及耐药性对比分析  

Comparison of clinical distribution and drug resistance of Pseudomonas aeruginosa between elderly and adult patients

作　　者：万小旭 王佳贺[1] WAN Xiao-xu;WANG Jia-he(Department of Geriatrics,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院老年病科

出　　处：《实用老年医学》2020年第1期42-45,共4页Practical Geriatrics

摘　　要：目的分析老年和中青年病人铜绿假单胞菌感染的分布及耐药性特点,为临床用药提供依据。方法以2016年1~12月就诊于我院的老年和中青年病人为研究对象,将标本全部按照全国临床检验操作规程进行细菌的分离培养,并对细菌的药敏结果进行分析。结果共检出铜绿假单胞菌427株,来自于老年病人232株(老年组,占54.33%),中青年病人195株(中青年组,占45.67%)。2组铜绿假单胞菌的标本来源无明显差异,均主要来源于痰液,分别占61.21%和57.44%。铜绿假单胞菌感染的老年病人主要分布在呼吸科、普通外科及重症监护室等科室,分别占23.28%、20.69%及14.22%;中青年病人主要分布在ICU、普通外科及神经外科等,分别占20.51%、14.87%及14.87%。老年病人的铜绿假单胞菌对庆大霉素、阿米卡星、美罗培南、左氧氟沙星等的耐药率在15%以下,对氨苄西林/舒巴坦、氨苄西林、复方新诺明等的耐药率均在98%以上,而对阿莫西林/克拉维酸、替加环素及头孢西丁等的耐药率达100%。中青年病人的铜绿假单胞菌对阿米卡星、左氧氟沙星、哌拉西林及妥布霉素的耐药率在15%以下,对氨苄西林/舒巴坦、氨苄西林、复方新诺明等的耐药率在98%以上,而对呋喃妥因、头孢替唑及头孢唑啉的耐药率达100%。结论老年与中青年病人铜绿假单胞菌的分布及耐药性存在一定的差异。其中,在呼吸科中发生的铜绿假单胞菌感染,老年病人比中青年病人多见。在神经外科及耳鼻喉科中发生的铜绿假单胞菌感染,中青年病人比老年病人多见。Objective To investigate and compare the distribution and drug resistance of Pseudomonas aeruginosa in the elderly and adult patients,and to provide the basis for clinical reasonable medication. Methods From January to December 2016,the laboratory specimens were collected in accordance with National Clinical Laboratory Procedures for bacterial isolation and culture. The drug susceptibility results were based on the American Clinical and Laboratory Standards Association standard.Results A total of 427 strains of Pseudomonas aeruginosa included 232 strains coming from elderly patients( 54. 33%) and 195 strains from adult patients( 45. 67%). The main specimens of Pseudomonas aeruginosa in the elderly and adult patients were mainly from sputum. Pseudomonas aeruginosa in the elderly patients were mainly distributed in Department of Respiratory Medcine,General Surgery and Intensive Care Unit, accounting for 23. 28%, 20. 69% and 14. 22% respectively. Pseudomonas aeruginosa in the adult patients were mainly distributed in Department of Intensive Care Unit,General Surgery and Neurosurgery,accounting for 20. 51%,14. 87% and 14. 87% respectively. The resistant rates of Pseudomonas aeruginosa in the elderly patients to gentamicin, amikacin, meropenem and levofloxacin were lower than 15%. However,the resistant rates to ampicillin/sulbactam,ampicillin,cotrimoxazole,nitrofurantoin were all above 98%. And the resistance rates to amoxicillin/clavulanic acid,tigecycline and cefoxitin were 100%. The resistant rates of Pseudomonas aeruginosa in the adult patients to amikacin,levofloxacin,piperacillin and tobramycin were lower than 15%,and the resistant rates to ampicillin/sulbactam, ampicillin, cotrimoxazole were above 98%, and the resistant rates to nitrofurantoin,cefotazole and cefazolin were 100%. Conclusions Distribution and drug resistance of Pseudomonas aeruginosa show difference between elderly and adult patients. In the Department of Respiratory Medcine,the infection rate of Pseudomonas aeruginosa in the elderly patients is

关 键 词：铜绿假单胞菌 老年病人 中青年病人 临床分布 耐药性 

分 类 号：R515[医药卫生—内科学]