老年慢性阻塞性肺疾病患者医院感染病原菌的临床分析

目的:探讨老年慢性阻塞性肺疾病(COPD)患者发生医院感染病原菌分布特点及感染危险因素,以指导临床治疗和预防。方法:回顾性分析2012年12月-2013年12月本院569例老年COPD患者的临床资料,观察患者医院感染发生率,并对发生感染患者的痰液、血液或尿液进行分离培养。结果:569例老年COPD患者中有86例发生医院感染,发生率为15.1%;感染患者送检的标本中共分离出病原株105例,其中革兰氏阴性菌64株占61.0%,革兰氏阳性菌29株占27.6%,真菌12株占11.4%;高龄、慢性病(高血压、冠心病、糖尿病等)、长期卧床、侵入性操作是老年COPD患者发生医院感染的主要危险因素。结论:老年COPD患者医院感染发生率较高,年龄≥80岁、合并慢性疾病(高血压、冠心病、糖尿病等)、长期卧床、侵入性操作均为导致医院感染的危险因素。

Clinical Analysis of Pathogenic Bacteria Infection in Elderly Patients with Chronic Obstructive Pulmonary Disease

Objective To investigate the distribution characteristics of pathogenic bacteria and risk factors for nosocomial infection in elderly patients with chronic obstructive pulmonary disease（ COPD）,and to guide the clinical treatment and prevention. Methods The clinical data of 569 elderly patients with COPD was retrospectively analyzed from December 2012 to December 2013. The incidence of nosocomial infection was calculated,meanwhile the pathogenic bacteria were isolated from sputum,blood or urine samples of infected patients and then cultured in vitro. Results The incidence of nosocomial infection was 15. 1%（ 86 /569） in these patients; total 105 strains of pathogenic bacteria were isolated from the samples of infected patients,including 64 strains of gram negative bacteria accounted for 61. 0%,29 strains of gram positive bacteria accounted for 27. 6% and 12 strains of fungi accounted for 11. 4%. Furthermore,the increased incidence of nosocomial infection were closely related to the advanced age,chronic diseases（ hypertension,coronary heart disease,diabetes and so on）,long-term bedridden and invasive operation in elderly patients with COPD. Conclusion The incidence of nosocomial infections is higher in elderly COPD patients than the others,and the main risk factors are aged over 80 years,chronic disease,long-term bedridden and invasive operation.