某院90例老年社区获得性肺炎患者感染病原菌的药敏结果与专项护理干预对临床用药的影响  

Influence of Pathogens’ Drug Sensitivity and Special Nursing Intervention on Clinical Medication in 90 Elderly Patients with CAP

作　　者：赖文婷 LAI Wen-ting(Emergency Department,Guangzhou No.1 People's Hospital,Guangzhou 510000,China)

机构地区：[1]广州市第一人民医院急诊科,广州510000

出　　处：《抗感染药学》2021年第8期1118-1121,共4页Anti-infection Pharmacy

摘　　要：目的:探究老年社区获得性肺炎(community-acquired pneumonia,CAP)患者感染病原菌的药敏结果与专项护理干预对临床用药的影响。方法:选取医院2019年11月—2020年11月收治的老年CAP患者90例病历资料,分析其CAP患者入院后痰液标本的病原菌培养与药敏结果以及实施专项护理干预对临床用药的指导价值。结果:90例老年CAP患者标本中,分离出病原菌132株,其中革兰阴性菌104株(占78.79%)、革兰阳性菌18株(占13.64%)和真菌10株(占7.57%);革兰阴性菌以铜绿假单胞菌及肺炎克雷伯菌为主,而革兰阳性菌以肺炎链球菌为主;药敏试验结果发现,铜绿假单胞菌对氨苄西林-舒巴坦钠和庆大霉素耐药率分别为77.78%和51.11%,而肺炎克雷伯菌对氨苄西林-舒巴坦钠的耐药率大于54%,革兰阳性菌中肺炎链球菌对环丙沙星和青霉素的耐药率分别为90.00%和50.00%。结论:老年CAP患者感染病原菌以革兰阴性杆菌感染为主,且分离菌耐药率较高,临床应加强专项护理干预,定期监测病原菌分布及耐药变化,科学合理使用抗菌药物。Objective: To explore the influence of the pathogens’ drug sensitivity and special nursing intervention on clinical medication in elderly patients with community-acquired pneumonia(CAP). Methods: The medical records of 90 elderly CAP patients admitted to our hospital from November 2019 to November 2020 were selected to analyze the pathogenic bacteria culture and drug sensitivity results of sputum samples of CAP patients after admission, as well as the guiding value of special nursing intervention for clinical drug use. Results: 132 strains of pathogenic bacteria were isolated from 90 samples of elderly CAP patients, among whom 104 strains of Gram-negative bacteria accounted for 78.79%, 18 strains of Gram-positive bacteria accounted for 13.64% and 10 strains of fungi accounted for 7.57%.Pseudomonas aeruginosa and Klebsiella pneumoniae were the main strains of Gram-negative bacteria, while Streptococcus pneumoniae were the main strains of Gram-positive bacteria. The drug susceptibility test results showed that the drug resistance rates of Pseudomonas aeruginosa to ampicillin-sulbactam and gentamicin were 77.78% and 51.11%, respectively, while the drug resistance rates of Klebsiella pneumoniae to ampicillin-sulbactam were more than 54%. The resistance rates of Streptococcus pneumoniae to ciprofloxacin and penicillin were 90.00% and 50.00%, respectively.Conclusion: Gram-negative bacilli were the main pathogenic bacteria in elderly CAP patients, and drug resistance rate of isolated bacteria was high. Therefore, special nursing intervention should be strengthened in clinical practice, the distribution of pathogenic bacteria and changes in drug resistance should be monitored regularly, and antibacterials should be used scientifically and rationally.

关 键 词：社区获得性肺炎 病原菌培养 耐药性分析 专项护理干预 临床用药 

分 类 号：R915[医药卫生—微生物与生化药学] R197.323.4[医药卫生—药学]