摘要
目的探讨老年重症肺炎患者感染病原菌分布和耐药率,为疾病的防治提供经验及临床合理用药提供依据。方法回顾性分析医院2010年1月-2014年1月重症医学科二区收治的164例老年重症肺炎患者临床资料,API鉴定系统对痰液标本进行菌株的分离和鉴定,药敏试验采用K-B纸片扩散法,数据采用Excel表格进行分析。结果 164例老年重症肺炎患者共检出病原菌146株,其中以革兰阴性菌为主,共97株占66.44%,最常见的革兰阴性菌依次为鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌和嗜麦芽寡养单胞菌;鲍氏不动杆菌对氨苄西林、头孢唑林耐药率较高,分别为100.00、93.75%,对亚胺培南、环丙沙星和阿米卡星耐药率低,均<30.00%;铜绿假单胞菌对环丙沙星、阿米卡星敏感,耐药率分别为20.83%、16.678%,对氨苄西林、头孢唑林耐药率较高,分别为83.33%、95.83%。结论老年重症肺炎仍以革兰阴性菌感染为主,各菌株均表现出了较高的耐药性,多药耐药情况严重,临床应该根据病原学结果合理选择抗菌药物。
OBJECTIVE To explore the pathogen distribution and resistance of senile severe pneumonia ,in order to provide experience for disease prevention and control and provide basis for clinical rational drug use .METHODS The 164 cases of senile severe pneumonia admitted in the critical care medicine ward Ⅱ in our hospital from Jan . 2010-Jan .2014 were retrospectively analyzed ,the separation and identification of strains from sputum specimens were conducted by API identification system , the drug sensitive test was conducted by the K‐B disk diffusion method .The software EXCEL was used for data analysis .RESULTS Totally 146 pathogenic bacteria were detec‐ted in the 164 cases ,mainly including 97 strains of gram‐negative bacteria accounting for 66 .44% .The most com‐mon gram‐negative bacteria were Acinetobacter baumannii ,Pseudomonas aeruginosa ,Klebsiella pneumoniae and Stenotrophomonas maltophilia .A .baumannii had high resistance to ampicillin and cefazolin ,with the resistance of 100 .00% and 93 .75% and low resistance to imipenem ,ciprofloxacin and amikacin ,all 〈30 .00% . Pseudo‐monas aeruginosa was sensitive to ciprofloxacin and amikacin with the resistance of 20 .83% and 16 .678% ,re‐spectively ,while it had higher resistance to ampicillin and cefazolin ,being 83 .33% and 95 .83% ,respectively . CONCLUSION Senile severe pneumonia is still mainly gram‐negative bacteria infection ,all the strains show high resistance with severe multi‐drug resistance ,clinicians should reasonably select antibacterial agents according to the etiological results .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第15期3411-3413,共3页
Chinese Journal of Nosocomiology
基金
广西卫生厅科研基金资助项目(z2011443)
关键词
重症肺炎
老年患者
病原菌
耐药性
Severe pneumonia
Senile patients
Pathogenic bacteria
Drug resistance
