ICU病房老年患者下呼吸道院内感染病原菌及其耐药性分析

目的探讨综合性重症监护病房(ICU)老年患者下呼吸道感染的病原菌分布及其耐药情况。方法收集2004年7月至2004年12月入住ICU的73例老年患者的痰标本进行细菌学培养及药物敏感性试验。结果老年患者下呼吸道感染发病率高,广谱抗生素使用是细菌耐药的主要原因之一。73例老年患者中35例发生下呼吸道感染,共分离出菌株71株,其中产超广谱β内酰氨酶(ESBLs)菌株15株。下呼吸道中最常见病原菌为铜绿假单胞菌、肺炎克雷伯杆菌、表皮葡萄球菌、真菌。在71株病原菌中,G-杆菌占46.5%,G+菌占35.2%,真菌占18.3%。结论ICU内老年患者下呼吸道感染的病原菌以G-杆菌为主,病原菌显示多重耐药。G-杆菌对亚胺培南敏感性较好,而G+菌对万古霉素有较高的敏感性,白色念株菌对大扶康的敏感性较好。

Clinical investigation of pathogens and their drug resistance in senile patients with lower respiratory tract infection in intensive care unit

Objective To investigate the distribution of pathogens and their antibiotic resistance in senile patients with lower respiratory tract infection in general intensive care unit.Methods Pathogens isolated in sputum from the patients admitted were collected and analyzed during July 2004 to December 2004.Results The mobidity of Lower respiratory tract infection was high.The use of extened-spectrum antibiotics was the common cause.A total of 73 pathogens were identified from the sputum in 35 cases out of 73 patients.The number of extened-spectrumβ-lactamases-producing strains were 15.The most common pathogens in lower respiratory tract were pseudomonas aeruginosa,and staphlococcus epidermidis and fungi.Among 71 strains,39.7 % were gram-negative bacteria,37.6 % were gram positive cocci and 22.7% were fungi.Conclusions gram-negative bacteria which present with multi-drug resistant are the most common pathogens,they are sensitive to imipenem,and Gram positivee bacteria are sensitive to vancomycin.Common fungi are sensitive to fluconazole