【摘要】 目的探讨老年患者下呼吸道感染常见病原菌分布及其耐药情况,为临床合理用药提供依据。方法对本院2010年1月至2013年12月老年患者下呼吸道痰标本分离的病原菌用VITEK32全自动细菌鉴定仪进行鉴定,用K-B纸片法进行体外药敏试验,用WHONET 5.4软件进行统计学分析。结果共分离出病原菌936株,其中革兰阴性菌655株(69.98%),前四位为肺炎克雷伯杆菌、大肠埃希菌、铜绿假单胞菌和鲍氏不动杆菌,占比分别为24.89%、18.38%、11.97%和8.01%;革兰阳性菌196株(20.94%),前三位为金黄色葡萄球菌、溶血葡萄球菌和肠球菌属,占比分别为10.15%、4.70%和3.10%;真菌85株(9.08%)。药敏结果显示,主要革兰阴性菌对阿米卡星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦和亚胺培南耐药率较低;主要革兰阳性菌对呋喃妥因、利福平、阿米卡星、替加环素、利奈唑胺和万古霉素耐药率较低。结论老年患者下呼吸道感染病原菌以革兰阴性杆菌为主,并出现多重耐药,临床应根据药敏结果合理选择抗菌药物。更多还原

【Abstract】 Objective To investigate the distribution of pathogenic bacteria and its drug resistance in senile patients with lower respiratory tract infection to guide rational drug use. Methods The sputum specimens were collected from elderly patients with lower respiratory tract infection from Jan. 2010 to Dec. 2013; the pathogenic bacteria were identified by using VITEK32; K-B method was used for the antibiotics susceptibility test; the resulting data were analyzed by WHONET 5. 4 software. Results A total of 936 strains of bacteria were isolated,including 655 strains of Gram-negative bacilli( 69. 98%); the top four pathogens were Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa and Acinetobacter baumannii,accounting for 24. 89%,18. 38%,11. 97% and 8. 01%,respectively. Gram-positive bacteria were 196 strains( 20. 94%); the top three pathogens were Staphylococcus aureus,Staphylococcus haemolyticus and Enterococcus,accounting for 10. 15%,4. 70% and 3. 10%,respectively.85 strains were fungi( 9. 08%). The main Gram-negative bacilli showed low drug resistance to Amikacin,Piperacillin / tazobactam,Cefoperazone / sulbactam and Imipenem,while main Gram-positive bacteria showed low drug resistance to Nitrofurantoin,Rifampicin,Amikacin,Tigecycline,Linezolid and Vancomycin. Conclusion Gramnegative bacilli are the major pathogens in senile patients with lower respiratory tract infection,and are multi-drug resistant; antimicrobials should be selected reasonably based on the results of drug susceptibility test.更多还原