摘要
目的了解老年患者下呼吸道感染病原菌分布及耐药特点。方法回顾性分析2003年1月-2005年12月，460例老年下呼吸道感染患者痰标本细菌培养及药敏试验结果。结果共分离出病原菌315株，其中革兰阴性杆菌245株（77．8％），革兰阳性球菌70株（22．2％）；检出依次为肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌、铜绿假单胞菌、嗜麦芽寡养单胞菌；真菌136株，以白色念珠菌为主，占60．3％；肺炎克雷伯菌和大肠埃希菌的ESBLs阳性率分别为50．7％和75．7％，对β-内酰胺类抗菌药物的耐药率〉50．0％，部分达80．0％～100．0％；碳青酶烯类抗菌药物对肠杆菌科细菌仍保持100．0％的抗菌活性；铜绿假单胞菌对多种抗菌药物的敏感性下降，部分耐药率达100．0％。结论老年患者下呼吸道感染的病原菌以肺炎克雷伯菌和大肠埃希菌为主，鲍氏不动杆菌、铜绿假单胞菌和嗜麦芽寡养单胞菌等非发酵菌以及真菌感染日趋增加，值得关注。
OBJECTIVE To comprehend the distribution and resistance to antimicrobial agents of the pathogenic bacteria causing lower respiratory tract infection in senile patients. METHODS We analyzed the distribution and resistance of the pathogenic bacteria isolated from 460 sputa samples of aged peoples with lower respiratory tract infection from Jan 2003 to Dec 2005. RESULTS A total of 315 strains of bacteria included 245（77. 8%） of Gram- negative bacilli and 70 （22.2 % ） of Gram-positive cocci were isolated. The height of isolation rate of bacteria in the first 5 was as follows in order： Klebsiella pneumoniae 〉 Escherichia coli〉 Acinetobacter baumannii Pseudomonas aeruginosa〉 Stenotrophomonas maltophilia. At the same time 136 strains of fungi were isolated. Candida albicans was the most predominant accounted for 60.3%. 50. 7% Strains of K. pneumoniae and 75.7% strains of E. coli produced ESBLs. The resistance rates of all K. pneumoniae and E. coli to β-lactams were above 50%. All isolates of Enterobacteriaceae were sensitive to imipenem or meropenem. The activity of antibacterial agents against P. aeruginosa was coming down. CONCLUSIONS K. pneumoniae and E. coli are the major pathogens in senile patients with lower respiratory tract infection. Increasing of nonfermenters and fungi as an infection should bring great concern.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2007年第2期230-233,共4页
Chinese Journal of Nosocomiology
关键词
病原菌
抗药性
下呼吸道感染
老年患者
Pathogen
Drug resistance
Lower respiratory tract infection
Senile patient
