老年脓毒症的流行病学特点  

Epidemiological characteristics of sepsis in the elderly

作　　者：尚召明 陈明泉 SHANG Zhaoming;CHEN Mingquan(Emergency Department,Huashan Hospital,Fudan University,200040 Shanghai,China)

机构地区：[1]复旦大学附属华山医院急诊科,上海市200040

出　　处：《实用老年医学》2025年第4期325-329,共5页Practical Geriatrics

摘　　要：脓毒症是老年人群感染相关死亡的核心原因。本文阐述了老年脓毒症的流行病学特点:全球范围内,老年脓毒症发病率与死亡率随年龄增长显著上升,且地区差异显著;病原学以革兰氏阴性菌(大肠杆菌、肺炎克雷伯菌)为主,耐药菌(如耐药甲氧西林金黄色葡萄球菌)感染风险加剧;常见感染部位为肺部、尿路和腹部,中枢神经系统感染死亡率最高;危险因素包括年龄、合并症(心血管疾病、代谢性疾病、慢性器官功能障碍)、免疫衰老及医源性因素。这些提示我们未来需强化早期诊断、优化抗生素策略及个体化治疗,以降低老年脓毒症负担。Sepsis is a core cause of infection-related mortality in the elderly.This article describes the epidemiological characteristics of sepsis in the elderly.Globally,the incidence and mortality rates of sepsis in the elderly increase significantly with age,and there are significant regional differences;Etiologically,Gram-negative bacteria(Escherichia coli,Klebsiella pneumoniae)are predominant,and the risk of infection with drug-resistant bacteria such as methicillin-resistant Staphylococcus aureus is increasing;Common sites of infection are lung,urinary tract and abdomen,and the mortality rate of central nervous system infection is the highest;Risk factors include age,comorbidities(cardiovascular diseases,metabolic diseases,chronic organ dysfunction),immunosenescence,and iatrogenic factors.These suggest that we need to strengthen early diagnosis,optimize antibiotic strategies,and implement individualized treatment to reduce the burden of sepsis in the elderly in the future.

关 键 词：老年人 脓毒症 流行病学 病原学 感染部位 危险因素 

分 类 号：R631[医药卫生—外科学]