呼吸内科老年患者下呼吸道感染病原菌分布及其耐药性分析

目的:探讨呼吸内科老年患者下呼吸道感染病原菌分布及其耐药性,并对大肠埃希菌、肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)的情况进行了研究。方法:取患者痰标本做细菌培养,检出病原菌,用K irby-Bauer纸片扩散法测定药敏,以表型确认法检测ESBLs菌株。结果:从2 177份痰标本中共分离出致病菌521株,其中G-杆菌389株),G+球菌81株,真菌51株。G-杆菌中以不动杆菌、克雷伯菌为主,对常用抗生素具有较高的耐药性;ESBLs总阳性率为23.3%,其中大肠埃希菌为19.1%,肺炎克雷伯菌为26.0%。结论:呼吸内科老年患者下呼吸道感染以G-杆菌为主,而且耐药性较高,今后应加强病原菌及药敏监测,以指导临床合理使用抗菌药物。

The distribution of pathogens and their drug resistance in senile patients with lower respiratory tract infection:A clinical investigation

Objective: To investigate the distribution and drug resistance of bacteria causing lower respiratory tract infection in senile patients in department of respiratory diseases,and study the prevalence of the bacteria producing extended-spectrum β-lactamases(ESBLs) in Escherichia coli and Klebsiella pneumoniae.Methods: The specimen of sputum was tested by culture to inspect pathogens.Kirby-Bauer agar diffusion method was used to judge drug sensitivity.Phenotypic confirmatory test was used to detect ESBLS.Results: A total of 521 strains were obtained from specimen of 2 177 sputum.Among which 389 strains were Gram-negative bacilli,81 strains were Gram-positive coccus,51 strains were fungus.The predominant pathogens in Gram-negative bacilli were Acinetobacter baumanii and Klebsiella pneumoniae,and showed high resistance to common antibiotics.The total percentage of ESBLsproducing was 23.3%,in which Escherichia coli was 19.1%,and Klebsiella pneumoniae was 26.0%.Conclusions: The Gram-nagative bacilli was the major pathogens isolated from senile patients with lower respiratory tract infection in department of respiratory diseases,and it has markedly increased resistance to common antibiotics.The monitoring for pathogens and drug sensitivity should be enhanced to give clinicians suggestion for rational use of antibiotics.