【摘要】 目的 探究老年慢性共病合并医院获得性肺炎患者的病原菌分布特征及耐药情况，为临床提供针对性参考依据。方法回顾性选取2023年8月—2025年7月在衡水市第二人民医院就诊的86例老年慢性共病合并医院获得性肺炎患者为研究对象，收集患者痰标本进行病原菌分离培养，用纸片扩散法评估耐药性。结果 从86例患者痰标本中分离到95株病原菌，以肺炎克雷伯菌(24.21%)、铜绿假单胞菌(17.89%)等革兰阴性菌最常见。合并慢性阻塞性肺病是最常见的慢性共病类型，占59.30%，检出病原菌54株，其中铜绿假单胞菌的检出率最高(27.78%)。分离的肺炎克雷伯菌对氨苄西林、头孢噻肟、头孢曲松的耐药率较高，分别为69.57%、56.52%、52.17%；铜绿假单胞菌对氨苄西林、头孢噻肟、头孢曲松的耐药率较高，分别为47.06%、41.18%、35.29%；金黄色葡萄球菌对氨苄西林、红霉素、克林霉素的耐药率分别为50.00%、42.86%、35.71%。结论 老年慢性共病合并医院获得性肺炎患者感染的病原菌以肺炎克雷伯菌、铜绿假单胞菌等革兰阴性菌为主，不同病原菌耐药性存在差异。更多还原

【Abstract】 Objective To investigate the distribution characteristics and drug resistance profiles of pathogenic bacteria in elderly patients with chronic comorbidities complicated with hospital-acquired pneumonia,and to provide targeted reference basis for clinical practice. Methods A total of 86 elderly patients with chronic comorbidities complicated with hospital-acquired pneumonia who were admitted to Hengshui Second People’s Hospital from August 2023 to July 2025 were retrospectively enrolled as research subjects. The sputum samples of the patients were collected for pathogenic bacteria isolation and culture,the Kirby-Bauer disk diffusion method was used to assess drug resistance. Results A total of 95 strains of pathogenic bacteria were isolated from the sputum samples of 86 patients,with Gram-negative bacteria such as Klebsiella pneumoniae(24.21%) and Pseudomonas aeruginosa(17.89%) being the most common. Complicated chronic obstructive pulmonary disease(COPD) was the most prevalent type of chronic comorbidity,accounted for 59.30%,from which 54 strains of pathogenic bacteria were detected positive,among which Pseudomonas aeruginosa had the highest positive rate(27.78%).The isolated Klebsiella pneumoniae strains showed high drug resistance rates to ampicillin,cefotaxime and ceftriaxone,reaching 69.57%,56.52% and 52.17% respectively. The Pseudomonas aeruginosa strains exhibited high resistance rates to ampicillin,cefotaxime and ceftriaxone,at47.06%,41.18% and 35.29% respectively. For Staphylococcus aureus,the drug resistance rates to ampicillin,erythromycin and clindamycin were 50.00%,42.86% and 35.71% respectively. Conclusion The pathogenic bacteria causing infections in elderly patients with chronic comorbidities complicated with hospital-acquired pneumonia were dominated by Gram-negative bacteria such as Klebsiella pneumoniae and Pseudomonas aeruginosa,with differences in drug resistance observed among different pathogenic bacteria.更多还原