多重耐药菌在老年肺部感染中的临床研究

目的了解老年患者肺部感染多重耐药菌分布及耐药状况特点,以便指导临床用药,减少多重耐药菌产生,提高患者治愈率。方法采用回顾性调查的方法对402例老年肺感染患者痰细菌培养及药物敏感试验结果进行分析。结果共分离出病原菌192株,革兰阴性杆菌127株（66.1%）,革兰阳性球菌45株（23.4%）,真菌20株（10.4%）。药物敏感试验显示,所分离的病原菌对抗菌药物存在多重耐药性,不同病原菌对各种抗菌药物的耐药率差异较大;革兰阴性杆菌对氨苄西林耐药率最高,耐药率达91.3%,对美罗培南的耐药率最低,耐药率19.9%,肺炎克雷伯菌及大肠埃希菌ESBLs阳性率分别为53.5%和40.4%。结论老年肺部感染的主要病原菌为革兰阴性杆菌,且存在较严重的耐药现象,应针对病原菌合理选用抗菌药物。

Multiple Drug-resistant Bacteria in Pulmonary Infection in Clinical Research

Objective Understand elderly patients with pulmonary infection multiple drug-resistant bacteria distribution and drug resistance characteristic condition, in order to guide the clinical medication, reduce multiple drug-resistant bacteria produce, improve patient cure rate. Methods Using the method of retrospective survey of 402 patients with pulmonary infection of patients with sputum specimens, for bacterial culture identification and drug sensitive test, and the analysis of the results. Results A total of 192 strains pathogenic bacteria isolate, gram negative bacilli 127 strains （66.1%）, gram positive coccus 45 strains （23.4%）, fungal 20 strains（10.4%）. Drug sensitive test showed that the isolated pathogenic bacteria, the antibacterial drugs to exist multiple drug resistance, different pathogenic bacteria to all sorts of antibacterial drug resistant differences; Gram negative bacilli to ampicillin were the most resistant, resistant to 91.3%, the lowest meropenem respectively, 19.9% respectively, pneumonia crayresearch bacteria and escherichia coli ESBLs positive rate were 53.5% and 40.4% respectively. Conclusion The main pathogenic bacteria of the pulmonary infection of the elderly for gram negative bacillus, and there is a more serious resistance phenomenon, we should focus on pathogenic bacteria reasonable choice of antimicrobial agents.