老年人下呼吸道感染的常见病原菌及耐药性分析

①目的探讨老年患下呼吸道感染的常见病原菌及其对抗菌药物耐药性的影响。②方法回顾性分析2000～2003年痰培养细菌的耐药性资料。③结果老年患下呼吸道感染的致病菌以革兰阴性杆菌为主，占68．4％；其次为革兰阳性球菌和真菌，分别占22．4％和92％。铜绿假单胞菌成为老年患下呼吸道感染的首要致病菌，亚胺培南、头孢吡肟、阿米卡星、头孢哌酮-舒巴坦及哌拉西林对其敏感性较高。革兰阳性球菌耐药率较高，对头孢唑啉、红霉素、苯唑西林耐药率分别达63．6％～77.8％、72.7％-88.9％和72.7％～88．9％，但均对万古霉素敏感。④结论革兰阴性杆菌为老年患下呼吸道感染的主要病原菌，其中铜绿假单胞菌感染率最高，但革兰阳性球菌及真菌的感染也不容忽视。

Distribution of bacteriologic etiology and bacterial resistance in elder patients with lower respiratory tract infection

Objective To investigate the distribution of the bacteriologic etiology and bac terial resistance of clinical i-solates for the guidance of rational use of antibiotics. Methods Antimicrobial susceptibility to isolates from the sputum specimen of patients from 2000-2003 were analysed retrospectively. The statistical analysis were manipulated by SPSS. Results For all patients together, the most frequently isolated bacteria were gram - negative bacilli ( 68. 4% ) ,followed by gram - positive cocci (22.4%) and fungi (9.2%). In elder patients with lower respiratory tract infection, pseudomonas aeruginosa was the most important pathogeny and suscepitible to imipenem, cefepime, amikacin, cefoperazone -sulbactam and piperacillin. The resistant rates of gram - positive cocci to cefazolin,erythromycin and oxacillin were 63. 6% -77. 8% , 72. 7% - 88. 9% and 72.7% - 88.9% . However,all of the Gram - posit ive cocci were susceptible to vancomycin. Conclusion Gram - negative bacilli is the most significant pathogenic bacteria in elder patients with lower respiratory tract infection and the infection rate of pseudomonas aeruginosa is outstandingly high. On the other hand, the infec tion of gram - positive cocci and fungi would not be neglected.