摘要
目的:分析老年脓毒症休克患者病原菌的特点。方法:回顾性分析60例老年脓毒症休克患者的病原学资料,其中死亡组34例、存活组26例,比较两组患者一般资料、感染部位、病原学特点及病原菌药敏情况等。结果:老年脓毒症休克患者感染病灶有1.4(1.0,3.0)个,病灶主要为肺部、腹腔、泌尿系统;标本病原菌阳性检出率为43.7%;39例(65%)患者检出病原菌,其中G^-菌58.3%、真菌41.7%、合并细菌及真菌36.7%、G^+菌5.0%;对G^-菌敏感性≥60%的药物仅有碳氢酶烯类抗生素。两组病灶类型及数量、病原菌类型及数量等比较,差异无统计学意义(P>0.05)。结论:老年脓毒症休克的主要病原菌为高耐药性的G^-菌,且常合并真菌感染,在保证强有力抗G^-菌的同时应重视抗真菌治疗。
Objective： To analyze the pathogenic characteristics of elderly patients with septic shock. Methods ： We retrospectively analyzed the pathogenic profiles of 60 elderly patients with septic shock patients, of whom 34 died and 26 survived. The general characteristics, location of infection, characteristics of pathogens and drug susceptibility were compared. Results： The number of infected location in elderly patients with septic shock was 1.4 （1.0, 3.0）, with the lungs, abdomen and urinary tract being mostly affected. A positive rate of 43.7% was reported for all specimens. Pathogens, comprised of 58.3% of G- negative bacteria, 41.7% of fungus, 36. 7% of both G- negative bacteria and fungus and 5.0% of G~ positive bacteria, were detected in 65% of patients. Carbapenem was the single antibiotic retaining a≥60% sensitivity to G-negative bacteria. However, there was significant between-group difference in neither the category nor number of the infected location or pathogens （ all P 〉 0.05 ）. Conclusion ： Septic shock in elderly patients, mostly featured by highly resistant G- negative bacteria and the frequent combination with fungus, deserves implementation of anti-fungal therapy on the basis of sufficient antibiotics against G- negative bacteria infection.
出处
《广州医学院学报》
2012年第5期32-35,共4页
Academic Journal of Guangzhou Medical College
基金
梅州市科技计划项目(2012B61)
关键词
脓毒症
休克
老年
病原菌
sepsis
shock
elderly patients
pathogen
