摘要
目的分析老年患者医院感染现状与病原菌耐药情况,为临床提供参考依据。方法回顾性分析2016年1月-2017年12月于医院住院的老年患者(≥60岁)1 000例为研究对象,分析老年患者医院感染现状与病原菌耐药情况。结果 1 000例老年患者发生医院感染157例,医院感染率为15.70%。感染部位排前5位的为下呼吸道、泌尿道、皮肤软组织、血流感染和上呼吸道。送检的各类临床标本共检出病原菌845株,培养阳性率为61.81%(845/1367)。共检出革兰阴性菌527株占62.37%,以鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌和大肠埃希菌为主;革兰阳性菌54株占6.39%,以金黄色葡萄球菌为主;真菌264株占31.24%,以白假丝酵母为主;鲍氏不动杆菌对抗菌药物普遍耐药,对所有进行药敏试验的抗菌药物耐药率均>60.00%;铜绿假单胞菌对阿米卡星、庆大霉素和妥布霉素较敏感;肺炎克雷伯菌对亚胺培南、美罗培南等较敏感;大肠埃希菌对亚胺培南、呋喃妥因等较敏感;年龄、住院时间、侵入性操作、抗菌药物使用和患有脑血管病、恶性肿瘤为老年患者发生医院感染的影响因素(P<0.05)。结论老年住院患者是医院感染高危人群,针对易感因素采取有效预防控制措施,可以控制老年住院患者医院感染,降低医院感染率。
OBJECTIVE To analyze current status of nosocomial infections and bacteria resistance in elderly patients,so as to provide references for clinic treatment.METHODS A total of 1000 cases of hospitalized elderly patients（older than 60 years old）from Jan.2016 to Dec.2017 were retrospectively analyzed.The current status of nosocomial infections and bacteria resistance in elderly patients were analyzed.RESULTS Among 1000 elderly patients,157 cases had nosocomial infections,and the nosocomial infection rate was 15.70%.The top 5 nosocomial infection sites were lower respiratory tract,urinary tract,skin soft tissue,blood and upper respiratory tract.Among all clinic samples detected,845 strains of pathogenic bacteria were detected,and the positive rate was 61.81%（845/1367）.There were 527 strains of gram-negative bacteria,accounting for 62.37%,mainly Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumonia,and Escherichia coli,54 strains of gram-positive bacteria,accounting for 6.39%,mainly Staphylococcus sureus,and 264 strains of fungi,accounting for 31.24%,mainly Candida albicans.Acinetobacter baumannii showed normal resistance to antibiotics,and the resistant rates were larger than 60.00%.Pseudomonas aeruginosa was sensitive to amikacin,gentamicin and tobramycin.K.pneumoniae was sensitive to imipenem and meropenem.Escheruchia coli was sentitive to impienem and macrodantin.The age,length of hospital stay,invasive operation,antibiotics use,cardiac disease and cancer were the significant risk factors of nosocomial infections in elderly patients（P〈0.05）.CONCLUSIONElderly hospitalized patients are the high-risk groups of nosocomial infections,effective prevention and control measure targeting risk factors can reduce nosocomial infection rate in elderly patients.
作者
刘卫平
海云婷
郭天慧
张凯
白海波
李海林
焦月英
李昊雪
LIU Wei-ping;HAI Yun-ting;GUO Tian-hui;ZHANG Kai;BAI Hai-bo;LI Hai-lin;JIAO Yue-ying;LI Hao-xue(Inner Mongolia People＇s Hospital, Hohhot , Inner Mongolia 010010, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第11期1645-1649,共5页
Chinese Journal of Nosocomiology
基金
内蒙古自治区自然科学基金资助项目[2017MS(LH)0845]
中国医院协会基金资助项目(CHA-2016-026-053)
关键词
老年患者
医院感染
相关因素
耐药性
药敏试验
Elderly patient
Nosocomial infection
Risk factors
Drug resistance
Drug sensitive test
