重度老年痴呆患者医院获得性肺炎病原菌分布及药敏试验分析  

Retrospective Analysis of Etiology Of Hospital Acquired Pneumonia in Patients with Severe Alzheimer's Disease

作　　者：黄琦琦 冯婉霞 李成志 HUANG Qiqi;Feng Wanxia;LI Chengzhi(Department of Gerontology,Wu Zhongpei Memorial Hospital,Shunde District,Foshan 528000,Guangdong,China;Department of Respiratory and Critical Care Medicine,Guangdong Tongjiang Hospital,Foshan 528300,Guangdong,China)

机构地区：[1]佛山市顺德区伍仲珮纪念医院老年科,广东佛山528000 [2]广东同江医院呼吸与危重症医学科,广东佛山528300

出　　处：《中国药物滥用防治杂志》2023年第3期437-440,共4页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:分析重度老年痴呆患者医院获得性肺炎病原菌分布及药敏试验结果。方法:选取2010年1月—2020年12月广东省佛山市顺德区伍仲珮纪念医院住院的老年痴呆合并医院获得性肺炎病例102例,分析患者临床表现,探讨其病原学特点及药敏试验结果。结果:102例患者中以咳嗽、肺部湿啰音症状最常见,还常伴有发热、咳痰、胸痛症状。共分离出病原菌161株,其中革兰阴性菌占比最高(63.35%),以肺炎克雷伯菌(19.88%)、铜绿假单胞菌(14.91%)、大肠埃希菌(11.18%)较为常见;革兰阳性菌(22.98%)中金黄色葡萄球菌(12.42%)较为常见。肺炎克雷伯菌对美罗培南、亚胺培南、哌拉西林的耐药率较低,均为9.38%;铜绿假单胞菌对头孢哌酮的耐药率最低(8.33%);大肠埃希菌对亚胺培南耐药率最低(0.00%)。不同耐药菌对美罗培南的耐药率比较,差异无统计学意义(P>0.05);不同耐药菌对亚胺培南、头孢哌酮、哌拉西林的耐药率比较,差异有统计学意义(P<0.05)。结论:重度老年痴呆患者出现获得性肺炎的风险较高,以革兰阴性菌最为常见,不同耐药菌对不同抗菌药物的耐药率不同,应根据药敏试验结果选择药物。Objective:To analyze the pathogen distribution and drug sensitivity test results of hospital acquired pneumonia in patients with severe senile dementia.Methods:From January 2010 to December 2020,102 cases of senile dementia complicated with hospital acquired pneumonia hospitalized in Wu Zhongpei Memorial Hospital,Shunde District,Foshan City,Guangdong Province were selected.The clinical manifestations of the patients were analyzed,and their pathogenic characteristics and drug sensitivity test results were discussed.Results:Among the 102 patients,cough and lung moist rale were the most common symptoms,accompanied by fever,expectoration and chest pain.161 strains of pathogenic bacteria were isolated from 102 patients,of which gram-negative bacteria accounted for the highest proportion(63.35%),and Klebsiella pneumoniae(19.88%),Pseudomonas aeruginosa(14.91%)and Escherichia coli(11.18%)were common;Staphylococcus aureus(12.42%)was common in Gram-positive bacteria(22.98%).The resistance rates of Klebsiella pneumoniae to meropenem,imipenem and piperacillin were all 9.38%;The drug resistance rate of Pseudomonas aeruginosa to cefoperazone was the lowest(8.33%);The resistance rate of Escherichia coli to imipenem was the lowest(0.00%).There was no significant difference in the resistance rate of meropenem among different resistant bacteria(P>0.05).The drug resistance rates of imipenem,cefoperazone and piperacillin in different resistant bacteria were significantly different(P<0.05).Conclusion:The risk of acquired pneumonia in patients with severe Alzheimer's disease is high,and gram-negative bacteria are the most common.The drug resistance rates of different drug-resistant bacteria to diferent antibiotics are different.Drugs should be selected according to the results of drug sensitivity test.

关 键 词：重度 老年痴呆 医院获得性肺炎 病原学特点 

分 类 号：R446.5[医药卫生—诊断学] R749.16[医药卫生—临床医学]