老年非发酵菌肺炎耐药情况及危险因素分析  

Analysis of Drug Resistance and Risk Factors of Non-fermenting Bacteria Pneumonia in the Elderly

作　　者：宋波 苏毅[1] SONG Bo;SU Yi(Department of Emergency,Tianjin Union Medical Center,Tianjin 300121,China)

机构地区：[1]天津市人民医院急诊科,天津300121

出　　处：《中国药物滥用防治杂志》2023年第6期960-962,966,共4页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:研究老年非发酵菌肺炎的病原微生物种类、耐药性、转归及导致其发生的危险因素。方法:选取2021年10月—2022年9月我院急诊科病房住院的全部老年细菌性肺炎患者作为研究对象,统计病原菌种类、耐药性情况;另根据痰培养结果将患者分为病例组和对照组,比较两组一般资料、转归情况,并采用单因素分析和非条件Logistic回归方法分析老年非发酵菌肺炎的危险因素。结果:69例患者送检痰标本中共检出非发酵菌77株,前3名分别是铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽寡养单胞菌,其耐药率高;病例组住院时间长于对照组,无效和死亡的比例高于对照组,差异有统计学意义(P<0.05)。Logistic回归分析显示,胃管鼻饲(OR=4.570,95%CI:2.240~9.327)、卧床(OR=2.442,95%CI:1.165~5.120)是其发生的危险因素。结论:老年非发酵菌肺炎致病菌耐药率高,疗效差,胃管鼻饲、卧床是独立的危险因素,如何对危险因素进行改进需要做进一步的研究。Objective:To study the species,drug resistance,prognosis and risk factors of non-fermenting bacteria pneumonia in the elderly.Methods:All elderly patients with bacterial pneumonia hospitalized in the emergency department of our hospital from October 2021 to September 2022 were selected as the research objects,and the types and drug resistance of pathogenic bacteria were counted.In addition,the patients were divided into case group and control group according to the results of sputum culture.The general data and prognosis of the two groups were compared,and the risk factors of non-fermentative bacterial pneumonia in the elderly were analyzed by univariate analysis and unconditional logistic regression.Results:A total of 77 non-fermentative bacteria were detected in the sputum samples of 69 patients.The top three were Pseudomonas aeruginosa,Acinetobacter baumannii and Stenotrophomonas maltophilia,with high drug resistance rate.The hospitalization time of the case group was longer than that of the control group,and the proportion of invalid and death was higher than that of the control group,the difference was statistically significant(P<0.05).Logistic regression analysis showed that nasogastric tube feeding(OR=4.570,95%CI:2.240-9.327)and bed rest(OR=2.442,95%CI:1.165-5.120)were risk factors.Conclusion The drug resistance rate of non-fermenting bacteria pneumonia in the elderly is high,and the curative effect is poor.Nasal feeding and bed rest are independent risk factors.How to improve the risk factors needs further study.

关 键 词：老年 非发酵菌 肺炎 危险因素 

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