摘要
目的探讨老年社区获得性肺炎(CAP)患者的病原体分布及药敏率,为临床医师合理选择抗菌药物提供依据。方法回顾性分析医院2012年1-11月收治的232例老年CAP患者临床资料,病原学及药敏试验检测采用法国生物梅里埃公司VITEK-2全自动微生物分析仪及其药敏卡进行。结果共检测出病原体156株,其中革兰阴性杆菌98株占62.8%、革兰阳性菌5株占3.2%,真菌39株占25.0%,支原体属14株占9.0%;检出前4位的病原菌依次为白色假丝酵母菌、肺炎克雷伯菌、铜绿假单胞菌、鲍氏不动杆菌,分别占21.8%、14.7%、14.1%、12.8%;主要革兰阴性菌对阿米卡星的敏感率均≥95.0%,主要革兰阳性球菌对替考拉宁的敏感率均达100.0%。结论革兰阴性杆菌为老年CAP患者的主要病原菌,不同病原菌对同一抗菌药物敏感性存在差异,建议临床医师将经验用药与药敏结果相结合,据此选择抗菌药物。
OBJECTIVE To investigate the pathogenic distribution and drug sensitivity of community acquired pneumonia（CAP）in elderly patients so as to provide basis for the reasonable clinical use of antibiotics.METHODS Data from a total of 232 elderly CAP patients between Jan.2012 and Nov.2012 in a tertiary class-A hospital in Tianjin were retrospectively analyzed,with pathogens and drug sensitivity detection by the VITEK-2Compact automatic microorganism analyzer and drug sensitive card.RESULTS A total of 156 strains of pathogens were isolated,among which there were 98（62.8%）strains of gram-negative bacilli,5（3.2%）strains of grampositive bacteria,39（25.0%）strains of fungi,14（9.0%）strains of mycoplasma.The Candida albicans（21.8%）,Klebsiella pneumonia（14.7%）,Pseudomonas aeruginosa（14.1%）,and Acinetobacter baumannii（12.8%）ranked the top four species of pathogens.The gram-negative bacteria were highly sensitive to amikacin with all sensitivity≥95.0%.The gram-positive cocci were highly sensitive to teicoplanin with all sensitivity up to100.0%.CONCLUSIONThe main pathogens causing elderly CAP was gram-negative bacilli.The various species of pathogens causing lower respiratory tract infections varied significantly in drug sensitivity to the same antibiotics.Clinicians should choose antibiotics according to both the clinical experience and the drug sensitivity.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第4期777-779,共3页
Chinese Journal of Nosocomiology
基金
天津市卫生局科技基金资助项目(2013KZ099)
关键词
老年患者
社区获得性肺炎
病原体
抗菌药物
药敏试验
Elderly patients
Community acquired pneumonia
Pathogen
Antibiotics
Drug sensitivity test
