【摘要】 目的:分析老年重症肺炎患者感染病原菌的分布及其耐药性。方法:选取医院2017年7月—2020年7月间收治的老年重症肺炎患者100例病历资料,统计其病原菌培养和药敏试验结果,分析其病原菌的分布以及主要病原菌对抗菌药物的耐药特点。结果:100例患者痰液标本中,分离出89株病原菌,其中革兰阴性菌59株(占66.29%,以鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌为主)、革兰阳性菌24株(占26.97%,以溶血葡萄球菌、肺炎链球菌为主)和真菌6株占6.74%;革兰阴性菌中鲍曼不动杆菌、铜绿假单胞菌对头孢唑林、氨苄西林的耐药率较高,肺炎克雷伯菌对氨苄西林、头孢噻肟的耐药率较高;鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌对环丙沙星、阿米卡星、亚胺培南的耐药率较低;而革兰阳性菌中溶血葡萄球菌对哌拉西林的耐药率较高,肺炎链球菌对青霉素、庆大霉素的耐药率较高;而溶血葡萄球菌、肺炎链球菌对头孢唑林、亚胺培南、万古霉素的耐药率较低。结论:老年重症肺炎患者大多为革兰阴性菌感染为主,其次为革兰阳性菌;致病菌株以鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、溶血葡萄球菌、肺炎链球菌感染为主,且不同病原菌对各种抗菌药物的耐药特点各不相同,临床应结合药敏试验结果合理使用抗菌药物治疗,以及时控制感染,抑制疾病进展。更多还原

【Abstract】 Objective:To analyze the distribution and drug resistance of infective pathogens in elderly patients with severe pneumonia. Methods:The medical records of 100 elderly patients with severe pneumonia admitted to the hospital from July 2017 to July 2020 were selected,and the results of pathogen culture and drug sensitivity test were statistically analyzed to explore the distribution of pathogenic bacteria and the characteristics of resistance of main pathogenic bacteria to antibacterial drugs. Results:In the sputum samples of 100 patients,89 strains of pathogenic bacteria were isolated,among which 59 strains of Gram-negative bacteria accounted for 66.29%(mainly Acinetobacter baumannii,Pseudomonas aeruginosa and Klebsiella pneumoniae),24 strains of Gram-positive bacteria accounted for 26.97%(mainly Staphylococcus haemolyticus and Streptococcus pneumoniae) and 6 strains of fungi accounted for 6.74%. The drug resistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa to cefazolin and ampicillin were higher in Gramnegative bacteria,while the drug resistance rates of Klebsiella pneumoniae to ampicillin and cefotaxime were higher.The drug resistance rates of Acinetobacter baumannii,Pseudomonas aeruginosa and Klebsiella pneumoniae to ciprofloxacin,amikacin and imipenem were low. The drug resistance rates of Staphylococcus haemolyticus to piperacillin and Streptococcus pneumoniae to penicillin and gentamicin were higher in positive bacteria. The drug resistance rates of Staphylococcus haemolyticus and Streptococcus pneumoniae to cefazolin,imipenem and vancomycin were lower. Conclusion:Most of the elderly patients with severe pneumonia were infected with Gram-negative bacteria,followed by Gram-positive bacteria. Pathogenic strains in Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae,hemolytic Staphylococcus aureus,Streptococcus pneumoniae infection is given priority to,and different pathogenic bacteria of various antibacterial drug resistance characteristics of each are not identical,should be combined with clinical rational use of antimicrobial drugs,drug sensitive test results and control infection,inhibit the disease progression.更多还原