老年重症肺炎患者痰标本中病原菌分布及耐药性分析  

Analysis of distribution and drug resistance of pathogenic bacteria in sputum samples of elderly patients with severe pneumonia

作　　者：殷妍 刘剑萍[1] 潘传亮[1] Yin Yan;Liu Jianping;Pan Chuanliang(Second Ward of ICU,Department of Critical Care Medicine,Third People's Hospital of Chengdu City,Chengdu,Sichuan,610031,P.R.China)

机构地区：[1]成都市第三人民医院重症医学科ICU二病区,四川成都610031

出　　处：《老年医学与保健》2022年第4期833-836,共4页Geriatrics & Health Care

基　　金：四川省卫生健康委员会科研课题(20PJ207)。

摘　　要：目的 观察老年重症肺炎患者的病原菌分布及耐药性,旨在指导该类患者的临床治疗。方法 选取2019年7月—2021年8月于成都市第三人民医院重症医学科ICU二病区收治的110例老年重症肺炎患者,采集重症肺炎患者痰标本中病原菌分布情况,并分析病原菌耐药性。结果 入组110例老年重症肺炎患者中,共检出134株病原菌,包括革兰阴性菌84株,其中鲍氏不动杆菌占比最高(20.15%);革兰阳性菌39株,其中金黄色葡萄球菌占比最高(11.94%);真菌11株,其中白假丝酵母占比最高(5.22%)。鲍氏不动杆菌对氨苄西林和头孢吡肟耐药性较强,分别占比85.19%和66.67%;对亚胺培南和美罗培南耐药性不明显。铜绿假单胞菌对氨苄西林和头孢噻肟耐药性较高,分别占比100%和63.16%;对阿米卡星、亚胺培南和头孢哌酮耐药性不高。肺炎克雷伯菌对氨苄西林和头孢噻肟耐药性较高,分别占比94.44%和66.67%;对亚胺培南和美罗培南不耐药。金黄色葡萄球菌对青霉素耐药性较高,占比100%;对万古霉素不耐药。肺炎链球菌对青霉素耐药性较高,占比85.71%;对万古霉素不耐药。结论 重症肺炎患者对临床抗菌药物均存在不同程度的耐药性,临床应加强重症肺炎患者的病原菌情况分析,并对其耐药性进行准确筛查,以指导临床重症肺炎患者抗菌药物的合理使用。Objective To observe the distribution and drug resistance of pathogenic bacteria in sputum samples of elderly patients with severe pneumonia in order to guide the clinical treatment of these patients.Methods A total of 110 elderly patients with severe pneumonia admitted to Second Ward of ICU,Department of Critical Care Medicine,Third People’s Hospital of Chengdu City from July 2019 to August 2021 were selected.The distribution of pathogenic bacteria in sputum samples of patients with severe pneumonia was collected and analyzed,and the drug resistance of pathogenic bacteria was analyzed.Results Among the 110 elderly patients with severe pneumonia,134 pathogenic strains were detected,including 84 strains of Gram-negative bacteria,of which Acinetobacter baumannii accounted for the highest proportion(20.15%);including 39 strains of Gram-positive bacteria,of which Staphylococcus aureus accounted for the highest proportion(11.94%);including 11 strains of fungi,of which Pseudomonas albicans accounted for the highest proportion(5.22%).Acinetobacter baumannii was highly resistant to ampicillin and cefepime,accounting for 85.19% and 66.67%,respectively;its resistance to imipenem and meropenem was not obvious.Pseudomonas aeruginosa was highly resistant to ampicillin and cefotaxime,accounting for 100% and 63.16%,respectively;its resistance to amikacin,imipenem and cefoperazone was not high.Klebsiella pneumoniae was highly resistant to ampicillin and cefotaxime,accounting for 94.44% and 66.67%,respectively;it was not resistant to imipenem and meropenem.Staphylococcus aureus is highly resistant to penicillin,accounting for 100%;it is not resistant to vancomycin.Streptococcus pneumoniae was highly resistant to penicillin,accounting for 85.71%;it was not resistant to vancomycin.Conclusion The patients with severe pneumonia have different degrees of resistance to clinical antibiotics.In order to guide the rational use of antibiotics in patients with severe pneumonia,it is necessary to strengthen the analysis of pathogenic bacte

关 键 词：老年 重症肺炎 痰标本 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学] R563.1[医药卫生—临床医学]