老年病区常见病原菌构成及其耐药性变迁

发布时间：2018-06-30 06:18

本文选题：老年病区 + 老年患者　；参考：《中国感染控制杂志》2016年01期

【摘要】：目的分析老年病区分离的常见病原菌构成及其耐药性变迁,为临床合理使用抗菌药物提供参考。方法分析2009—2013年某院老年病区住院患者送检标本,对检出病原菌及耐药情况进行统计分析。结果 2009—2013年共检出病原菌7 426株,其中革兰阴性(G-)杆菌6 755株(占90.96%),革兰阳性(G+)球菌537株(占7.23%),真菌134株(占1.81%)。检出菌株数居前5位的依次为铜绿假单胞菌(39.16%)、大肠埃希菌(16.47%)、嗜麦芽窄食单胞菌(10.65%)、肺炎克雷伯菌(7.22%)及鲍曼不动杆菌(6.21%),居前5位的细菌标本来源主要为痰(5 573株,占94.15%)。鲍曼不动杆菌对检测的所有抗菌药物耐药率均呈上升趋势(均P0.01);铜绿假单胞菌对哌拉西林/他唑巴坦、头孢他啶、氨曲南、亚胺培南等8种常见抗菌药物,以及大肠埃希菌对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、氨曲南、左氧氟沙星及环丙沙星5种常见抗菌药物的耐药率均呈上升趋势(均P0.01);肺炎克雷伯菌对检测的所有抗菌药物耐药率均无明显变化(均P0.05)。嗜麦芽窄食单胞菌对头孢他啶和左氧氟沙星的耐药率呈上升趋势(均P0.01)。结论老年病区分离的病原菌以铜绿假单胞菌为主,其对多种常见抗菌药物耐药率高,且日趋严重,临床应根据药敏试验结果合理选用抗菌药物。
[Abstract]:Objective to analyze the common pathogens and their resistance changes in the geriatric area, and to provide a reference for the rational use of antibiotics in clinical practice. Methods the samples of hospitalized patients in the geriatric area of a hospital from 2009 to 2013 were analyzed. The pathogenic bacteria and drug resistance were analyzed. Results from 2009 to 2013, 7426 strains of pathogenic bacteria were detected. Gram-negative (G-) bacilli (90.96%), gram-positive (G+) coccus (7.23%) and fungus 134 (1.81%). The first 5 were Pseudomonas aeruginosa (39.16%), Escherichia coli (16.47%), Stenotrophomonas maltophilia (10.65%), Klebsiella pneumoniae (7.22%) and Acinetobacter Bauman (6.21%), which were the most important bacteria in the first place. The main source of the specimen was phlegm (5573 strains, 94.15%). The resistance rate of Acinetobacter sp. Bauman was increased (all P0.01); Pseudomonas aeruginosa was treated with piperacillin / tazobactam, ceftazidime, amamenan, imipenem and other 8 common antimicrobial agents, and Escherichia coli against piperacillin / tazobactam and cefperidin. The resistance rates of ketone / sulbactam, amamethanone, levofloxacin and ciprofloxacin were all increased (all P0.01), and Klebsiella pneumoniae had no significant changes in all antimicrobial resistance rates (P0.05). The resistance rate of Stenotrophomonas maltophilia to ceftazidime and levofloxacin was increased (P0.01). Conclusion the pathogenic bacteria isolated from the geriatric area are mainly Pseudomonas aeruginosa, and their resistance to a variety of common antibiotics is high and is becoming more and more serious. The antibiotics should be selected according to the results of drug sensitivity test.
【作者单位】：广州军区武汉总医院;
【分类号】：R446.5

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