老年患者下呼吸道感染的常见病原菌及耐药性分析

发布时间：2018-07-20 11:15

【摘要】：目的分析老年患者下呼吸道感染的常见病原菌分布情况及耐药性。方法选择2014年4月-2016年12月医院就诊48例老年急性下呼吸道感染患者,采用微生物半自动鉴定系统进行细菌分离及鉴定,通过K-B纸片扩散法进行药物敏感性试验,分析患者感染病原菌的分布情况及药敏试验结果。结果 48例老年急性下呼吸道感染患者痰培养标本中共分离出病原菌76株,其中革兰阴性菌46株,占60.5%;革兰阳性菌30株,占39.5%;老年急性下呼吸道感染患者分离的病原菌中革兰阴性菌对青霉素类,喹诺酮类,第三代以下头孢菌素,四环素类,部分氨基糖苷类等抗菌药物耐药性较高,部分可达100.0%,而对青霉素类+酶抑制剂、头孢菌素类+酶抑制剂、碳青霉烯类、阿米卡星等仍然较敏感,革兰阳性菌对青霉素类普遍耐药,但对部分头孢菌素类、万古霉素、替考拉宁、利福平、部分喹诺酮类等仍然较敏感。结论老年患者下呼吸道感染血培养分离的病原菌中以革兰阴性菌为主,且存在较严重的耐药现象,而部分氨基糖苷类,阿米卡星,青霉素类+酶抑制剂、头孢菌素类+酶抑制剂抗菌药物敏感性较高,应结合医院药敏试验结果针对性选用抗菌药物。
[Abstract]:Objective to analyze the distribution of common pathogenic bacteria and drug resistance of lower respiratory tract infection in elderly patients. Methods 48 patients with acute lower respiratory tract infection in the hospital in December -2016 in April 2014 were selected for isolation and identification by microbiological semiautomatic identification system, and the drug sensitivity test was carried out by K-B paper diffusion method. Results of the distribution of pathogenic bacteria and the results of drug sensitivity test. Results 76 strains of pathogenic bacteria were isolated from the sputum culture specimens of 48 elderly patients with acute lower respiratory tract infection, of which 46 were Gram-negative bacteria, 60.5% were Gram-negative bacteria, 30 strains of Gram-positive bacteria, 39.5%, and Gram-negative bacteria isolated from the elderly patients with acute lower respiratory infection were Penicillium. Quinolones, quinolones, third generations of cephalosporins, tetracycline, partial aminoglycosides, and some other antibiotics have higher resistance to 100%, while penicillins + enzyme inhibitors, cephalosporins + enzyme inhibitors, carbapenems, amikasum, etc. are still more sensitive, and Gram-positive bacteria are generally resistant to penicillins, but some of the cephalosporins are resistant to penicillins. Cyclosporin, vancomycin, teicoplanin, rifampicin, and partial quinolones are still more sensitive. Conclusions among the pathogenic bacteria isolated from the blood culture of lower respiratory tract infection in the elderly patients are Gram-negative bacteria, and there are more serious drug resistance, while some aminoglycosides, Amikacin, penicillins + enzyme inhibitors, cephalosporins + enzyme inhibition Antimicrobial agents are highly sensitive and should be selected according to the results of drug sensitivity test in hospitals.
【作者单位】：浙江省绍兴市中心医院呼吸内科;
【分类号】：R446.5;R56

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