老年肺炎患者病原菌的分布及耐药性分析

目的:探讨老年肺炎患者病原菌的分布及耐药状况,为临床合理应用抗菌药物提供帮助.方法:对300例老年肺炎患者的痰标本,进行细菌培养鉴定,用琼脂扩散法进行体外药物敏感试验并统计分析。结果:共分离出病原菌90株,革兰阴性杆菌51株(56.6%),主要分离菌依次为铜绿假单胞菌、肺炎克雷伯菌等;革兰阳性球菌6株(6.7%),以凝固酶阴性葡萄球菌为主,占4.4%。肠杆菌产超广谱酶(ESBLs)6株,占33.3%,耐甲氧西林凝固酶阴性的葡萄球菌(MRCNS)菌2株。真菌33株(36.7%),药物敏感试验显示,所分离的阴性杆菌对抗菌药物存在多药耐药性,铜绿假单胞菌耐药严重。结论:老年人肺炎的病原菌主要为革兰氏阴性杆菌,真菌感染日趋增加,临床应根据病原学的检测合理使用抗菌药物。

Pathogens Distribution and Analysis of Drug Resistance in Senile patients with Pneumonia

OBJECTIVE To study pathogens distribution and analysis of drug resistance in senile patients with pneumonia, in order to provide a basis for clinical rational drug use. METHODS The sputum and lower respiration secretion of 300 senile patients with pneumonia were cultured to detect pathogens which were confirmed by routine methods. The disk diffusion test was adopted to analyze drug resistantce. RESULTS Gram-negative bacterial rated the top one, reached 56.6% ;The detection rate followed by pseudomonas aerugiuosa, klebsiella pneumoniae, Escherlchia coli,etc. The Gram-positive cocci were 6 cases（6.7%）, the dominant were coagulase-negative Staphylococcus （4 strains,4.4%）.The fungi were 36.7%. ESBLs was 6strains and MRCNS was 2 strains.And extensive-spectrum beta-lactamases （ESBLs） occurred with rate of 33.3%. Gram-nagative bacilli were usually resistant to multiple antimicrobial agents,the drug resistance supervision manifested that the resis- tant rates of Pseudornonas aeruglnosa to the routine drugs were high . CONCLUSIONS The main pathogens of pneumonia in the elderly as a Gram-negative bacteria, and fungal infections is on the increase, the clinical should rationally use antibiotics according to etiological detection.