【摘要】 目的研究老年感染患者的病原菌分布及其对抗菌药物的耐药情况。方法将细菌纸片扩散法药敏测验的抑菌环直径输入计算机,根据2001年NCCLS颁布的准则,采用“WHONET-5”软件完成统计分析。结果湖北地区15所医院老年感染患者的3 505株临床分离菌中,革兰阳性菌占26.5%,革兰阴性菌占73.3%;49.4%的金黄色葡萄球菌和82.5%的其他类型葡萄球菌对苯唑西林耐药,但无万古霉素耐药株;3%的肠球菌属对万古霉素耐药;与1996年比较,铜绿假单胞菌对亚胺培南以及主要革兰阴性菌对多数抗菌药物(亚胺培南除外)耐药率均显著增加(P<0.05);大肠埃希菌和克雷伯菌属中产超广谱β-内酰胺酶(ESBLs)的菌株分别为21.4%和19.1%,高于1996年的17.7%和15.2%;产ESBLs菌株对除碳青酶烯类外多数抗菌药物的耐药率显著高于非产ESBLs菌株(P<0.05)。结论产ESBLs细菌感染增多是老年患者耐药率增加的原因之一,临床应加强对β-内酰胺酶的全面检测。更多还原

【Abstract】 OBJECTIVE To guide the clinical drug use by studying the distribution of pathogens isolated from senile patients and the drug resistance to antibiotics. METHODS The diameters of the inhibition zone of clinical isolates around antibiotic susceptibility test disk were filed by computer and analyzed by the software of "WHONET-5" according NCCLS document published in 2001. RESULTS Totally 3 505 strains including 2 569 strains(73.3%) of Gram-negative bacilli and 930 strains(26.5%) of Gram-positive cocci were collected and isolated from senile patients in 15 hospitals of Hubei Province during 2002.49.4% of Staphylococcus aureus and 82.5% of other staphylococci were resistant to oxacillin,3% of Enterococcus were resistant to vancomycin.The resistance rates of Pseudomonas aeruginosa to imipenem and major pathogens to amikacin,ceftazidime and ciprofloxacin were significantly higher than the data in 1996.21.4% of Escherichia coli and 19.1% of Klebsiella were detected to produce extended-spectrum β-lactamases(ESBLs),while 17.7% and 15.2% were in 1996.The resistant rates of ESBLs-positive strains were significantly higher than the negatives. CONCLUSIONS The increase in ESBLs positive pathogens is one of the reasons for higher resistance in senile patients.Clinical detection of β-lactamases should be generally put in practice.更多还原