MICU老年住院患者痰标本分离细菌及耐药率变迁  

Changes in bacteria isolation and drug resistance rate in sputum specimens of elderly hospitalized patients in MICU

作　　者：高卜文 张毅[1] GAO Bu-wen;ZHANG Yi(Department of Geriatrics,Shengjing Hospital of China Medical Unversity,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院干诊科,辽宁沈阳110004

出　　处：《实用药物与临床》2021年第4期366-371,共6页Practical Pharmacy and Clinical Remedies

基　　金：辽宁省自然科学基金项目(20170541004)。

摘　　要：目的分析我院MICU老年住院患者痰标本中分离出的主要病原菌种类及其耐药率变迁,为临床用药提供参考。方法收集我院2017年1月至2019年12月MICU年龄大于60岁老年住院患者的痰液标本,剔除同一患者的重复病原菌,进行菌株分离、培养鉴定及药敏试验,分析病原菌分布及耐药率情况。结果共分离出535株病原菌,其中革兰阴性杆菌502株,占93.8%,高于其他文献报道,革兰阳性球菌33例,占6.2%,常见病原菌前5位为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、嗜麦芽窄食单胞菌及金黄色葡萄球菌。结论我院MICU老年住院患者痰标本分离病原菌以革兰阴性菌为主,其中鲍曼不动杆菌感染情况最重,对多种药物耐药率偏高,应注意加强耐药菌耐药监测,根据药敏结果指导合理应用抗菌药物,加强医务人员掌握防控病菌感染的干预措施,有利于降低耐药菌感染率。Objective To analyze the main pathogenic bacteria species isolated from the sputum specimens of elderly inpatients in MICU in our hospital and the changes in drug resistance rate,so as to provide reference for clinical medication.Methods Sputum specimens were collected from hospitalized patients aged over 60 years in MICU from January 2017 to December 2019 in our hospital.The repeated pathogenic bacteria in the same patient were eliminated,and strains were isolated,cultured,identified and tested for drug susceptibility.The distribution of pathogenic bacteria and drug resistance rate were analyzed.Results Totally 535 strains of pathogenic bacteria were isolated from sputum specimens,including 502 strains of gram-negative bacilli,accounting for 93.8%,which was higher than that reported in other literatures.Gram-positive cocci were found in 33 cases,accounting for 6.2%.The first five common pathogenic bacteria were Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae,Stenotrophomonas maltophilce and Staphylococcus aureus.Conclusion Gram-negative bacteria are the main pathogenic bacteria in sputum specimens of the elderly patients hospitalized in MICU of our hospital,among which acinetobacter baumannii infection was the most serious.As the drug resistance rate of many drugs is relatively high,attention should be paid to strengthening the monitoring of drug resistance of drug-resistant bacteria and guiding the rational application of antibiotics according to the drug sensitivity results.At the same time,it is beneficial to reduce the infection rate of drug-resistant bacteria by means of intervention measures such as strengthening the training of medical personnel on the prevention of bacterial infection.

关 键 词：MICU 老年患者 痰培养 耐药率变迁 

分 类 号：R446.5[医药卫生—诊断学]