老年重症肺炎患者支气管肺泡灌洗液细菌培养及药敏分析  

Bacterial culture and drug sensitivity analysis for bronchoalveolar lavage fluid in elderly patients with severe pneumonia

作　　者：金玉女[1] 李海洋 党惠子[1] 杨柳 JIN Yunv;LI Haiyang;DANG Huizi(Department of Respiratory,Beijing Muslim Hospital,Beijing 100054,China)

机构地区：[1]北京市回民医院呼吸科,100054

出　　处：《河北医药》2024年第13期2052-2054,2060,共4页Hebei Medical Journal

摘　　要：目的 分析老年重症肺炎患者支气管肺泡灌洗液细菌构成及药敏情况。方法 纳入2022年3月至2023年8月收治的老年重症肺炎患者180例,对患者支气管肺泡灌洗液进行细菌培养和鉴定,采用最低抑菌浓度(MIC)法进行药物敏感试验分析。结果 180例老年重症肺炎患者支气管肺泡灌洗液共分离出217株病原菌,其中革兰阴性菌141株(64.98%),革兰阳性菌57株(26.27%),真菌19株(8.76%)。革兰阴性菌中肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌分布最广,肺炎克雷伯菌对阿米卡星、复方新诺明的敏感率较高,对哌拉西林、环丙沙星、氨苄西林/舒巴坦的耐药率较高;鲍曼不动杆菌对复方新诺明、妥布霉素的敏感率较高,对头孢他啶、头孢吡肟、头孢曲松的耐药率较高;铜绿假单胞菌对阿米卡星、哌拉西林/他唑巴坦、头孢吡肟的敏感率较高,对亚胺培南、哌拉西林、头孢他啶的耐药率较高。革兰阳性菌中肺炎链球菌、金黄色葡萄球菌分布最广,肺炎链球菌对万古霉素、利福平、青霉素的敏感率较高,对四环素、红霉素、克林霉素的耐药率较高;金黄色葡萄球菌对万古霉素、利福平、克林霉素的敏感率较高,对青霉素、庆大霉素、红霉素的耐药率较高。结论 老年重症肺炎患者支气管肺泡灌洗液的主要病原菌为革兰阴性菌,不同病原菌药敏分析结果差异较大,临床应根据药敏结果合理应用抗生素。Objective To analyze the bacterial composition and drug sensitivity for bronchoalveolar lavage fluid in elderly patients with severe pneumonia.Methods Totally 180 elderly patients with severe pneumonia visited our hospital from March 2022 to August 2023 were included.Bacterial culture and identification were performed on the bronchoalveolar lavage fluid of the patients,and drug sensitivity analysis was conducted using the minimum inhibitory concentration(MIC)method.Results Among 180 elderly patients with severe pneumonia,a total of 217 strains of pathogenic bacteria were isolated from their bronchoalveolar lavage fluid,including 141(64.98%)strains of Gram negative bacteria,57(26.27%)strains of Gram positive bacteria,and 19(8.76%)strains of Fungi.Among Gram-negative bacteria,Klebsiella pneumoniae,Acinetobacter baumannii,and Pseudomonas aeruginosa were the most widely distributed.Klebsiella pneumoniae had a higher sensitivity to amikacin and compound sulfamethoxazole,and a higher resistance to piperacillin,ciprofloxacin,and ampicillin/sulbactam.Acinetobacter baumannii had a high sensitivity rate to compound sulfamethoxazole and tobramycin,and a high resistance rate to ceftazidime,cefepime,and ceftriaxone.Pseudomonas aeruginosa had a high sensitivity rate to amikacin,piperacillin/tazobactam,and cefepime,while it had a high resistance rate to imipenem,meropenem,and ceftazidime.Among Gram positive bacteria,Streptococcus pneumoniae and Staphylococcus aureus were the most widely distributed.Streptococcus pneumoniae had a higher sensitivity to vancomycin,rifampicin,and penicillin,and a higher resistance to tetracycline,erythromycin,and clindamycin.Staphylococcus aureus had a high sensitivity to vancomycin,rifampicin,and clindamycin,while it had a high resistance to penicillin,gentamicin,and erythromycin.Conclusion The main pathogen of bronchoalveolar lavage fluid in elderly patients with severe pneumonia is Gram negative bacteria,and the drug sensitivity analysis results of different pathogens vary greatly.Therefore,anti

关 键 词：老年重症肺炎 支气管肺泡灌洗液 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]