老年呼吸道感染病原菌分布及耐药性分析

发布时间：2018-10-20 08:38

【摘要】：目的探讨老年呼吸道感染病原菌分布及耐药率,为临床防治细菌感染提供参考。方法选择老年呼吸道感染患者126例,对患者的病原菌进行临床检验分析。结果通过痰培养共检出92株病原菌,其中革兰阴性杆菌是引起感染的主要病原菌,共分离出53株,构成比为57.61%,所占比例从低到高依次为鲍曼不动杆菌、阴沟肠杆菌、大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌;革兰阳性球菌共分离出33株,构成比为35.87%,金黄色葡萄球菌、肺炎链球菌、表皮葡萄球菌和粪肠球菌所占比例最高;真菌共分离出6株,构成比为6.52%,白假丝酵母菌和热带假丝酵母菌所占比例最高;2013年-2015年铜绿假单胞菌的ESBLs菌株检出率逐年上升,分别为33.33%,40.00%和50.00%,2013年-2015年肺炎克雷伯菌的ESBLs菌株检出率也逐年上升,分别为25.00%,42.86%和57.14%。结论老年患者容易受环境和自身因素影响,导致呼吸道感染发生,随着抗菌药物的普遍使用,耐药菌株迅速增加;临床上应根据患者症状、感染情况、药敏结果合理选用抗菌药物治疗。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and drug resistance rate in elderly patients with respiratory tract infection, and to provide reference for clinical prevention and treatment of bacterial infection. Methods 126 elderly patients with respiratory tract infection were selected for clinical analysis. Results 92 strains of pathogenic bacteria were detected by sputum culture, among which gram-negative bacilli were the main pathogens, 53 strains were isolated, the composition ratio was 57.61, the proportion was Acinetobacter baumannii and Enterobacter cloacae. Escherichia coli Pseudomonas aeruginosa Klebsiella pneumoniae 33 strains of Gram-positive cocci were isolated and the proportion of Staphylococcus aureus Streptococcus pneumoniae Staphylococcus epidermidis and Enterococcus faecalis was the highest. A total of 6 strains of fungi were isolated, with a composition ratio of 6.52. The proportion of Candida albicans and Candida tropicalis was the highest, and the detection rate of ESBLs strains of Pseudomonas aeruginosa increased year by year from 2013 to 2015. The detection rate of ESBLs strains of Klebsiella pneumoniae from 2013 to 2015 also increased year by year, being 25.00% 42.86% and 57.14% respectively. Conclusion elderly patients are susceptible to environmental and self-factors, which lead to respiratory tract infection. With the widespread use of antimicrobial agents, drug-resistant strains increase rapidly, and should be based on the symptoms and infection status of the patients. Antimicrobial therapy was reasonably selected for drug sensitive results.
【作者单位】：郑州大学第五附属医院呼吸内科;武汉大学中南医院呼吸内科;郑州大学第五附属医院胸外科;
【基金】：湖北省医学科研基金资助项目(B20143392)
【分类号】：R56

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