老年院内感染败血症的危险因素与病原菌特征

目的:分析老年院内感染败血症的危险因素及病原菌特征。方法:回顾性分析48例老年院内感染败血症患者的临床资料,对细菌菌株进行鉴定,并行药敏试验。结果:老年院内感染败血症的危险因素主要包括基础疾病、侵袭性操作、住院时间、大剂量化疗以及激素、抗生素的使用。48例患者共检出病原菌97株,其中革兰阴性杆菌73株(75.3%),革兰阳性球菌18株(18.6%),真菌6株(6.2%)。药敏试验结果显示,大肠埃希菌对碳青霉烯类敏感,对第3代头孢耐药明显;铜绿假单胞菌对氨基糖苷类及第3、4代头孢较敏感,对碳青霉烯类耐药明显;肺炎克雷白菌对氨基糖苷类、碳青霉烯类敏感,对头孢类及喹诺酮类耐药明显;金黄色葡萄球菌、粪肠球菌等对青霉素、苯唑西啉、头孢唑啉耐药明显。结论:对于老年败血症,应在治疗基础疾病的基础上强化院内感染的控制,加强营养支持治疗及抗生素的合理应用,及早对致病菌进行培养和药敏试验,以正确指导临床用药。

Risk factors and pathogenic characteristics of nosocomially infected septicemia in elderly patients

Objective:To analyze the risk factors and pathogenic characteristics of nosocomially infected septicemia in elderly patients.Methods:The clinical data of 48 elderly patients with nosocomially infected septicemia were retrospectively analyzed.The bacteria strains were identified,and the drug sensitive test was conducted.Results:The risk factors of nosocomially infected septicemia in elderly patients mainly included underlying diseases,invasive operations,hospital stays,large-dose chemotherapy as well as application of hormones and antibiotics.Among 48 patients,97 strains of pathogenic bacteria were identified totally,in which there were 73 strains of Gram-negative bacilli (75.3%),18 strains of Gram-positive coccus (18.6%) and 6 strains of fungus (6.2%).The drug sensitive test results revealed that escherichia coli were sensitive to carbapenems,tolerant to the third generation of cephalosporin;pseudomonas aeruginosa were sensitive to aminoglycosides and the third and fourth generations of cephalosporin,tolerant to carbapenems;klebsiella pneumonia were sensitive to aminoglycosides and carbapenems,tolerant to cephalosporin and quinolones;both staphylococcus aureus and enterococcus faecalis are tolerant to penicillin,oxacillin and cefazolin.Conclusion:For septicemia in elderly patients,we should enhance the control of nosocomial infection,nutritional support and reasonable application of antibiotics to accurately guide the clinical administration based on the treatment of underlying diseases.Additionally, cultivation and drug sensitive test of pathogenic bacteria should be performed early.