老年下呼吸道感染患者常见病原菌种类与药敏分析

目的监测老年患者下呼吸道感染常见病原菌种类,分析其对抗菌药物的耐药情况。方法医院2006年1-12月从304例老年下呼吸道感染患者的痰及下呼吸道分泌物中分离出178份阳性标本,对其病原菌种类及药敏结果进行综合分析。结果老年患者下呼吸道感染病原菌以革兰阴性杆菌为主,最常见的依次是铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌,这4种细菌对氨苄西林、头孢唑林、复方新诺明的耐药率均〉40%;产超广谱β-内酰胺酶（ESBLs）的肠杆菌科细菌共14株,检出率为29.8%。结论老年患者下呼吸道感染病原菌以革兰阴性杆菌为主,临床应积极开展痰细菌培养及药敏试验,合理使用抗菌药物,以早期诊断和控制老年患者下呼吸道感染。

Bacterial Distribution and Drug Resistance in Lower Respiratory Tract Disease among Aged People

OBJECTIVE To investigate the bacterial distribution and the extent of drug resistance in lower respiratory tract disease among aged people. METHODS From Jan 2006 to Dec 2006 we collected 304 sputum samples of the old patients who were diagnosed lower respiratory tract infection, bacterial distribution and antibiotic resistance of 178 strains of the pathogens were analyzed retrospectively. RESULTS The most common four kinds of Gram-negative bacilli were Pseudornonas aeruginosa, Klebsiella pneumoniae, Escherichia coli and Acinetobacter baumannii. For above bacteria, the ratio of the resistance to ampicillin, cefazolin and compound sulfamethoxazole was over 40%. The isolating rate of ESBLs-producing E. coli and K. pneumoniae was 29.8%. CONCLUSIONS Monitoring the common bacteria and ESBLs bacteria precisely can provide therapy, guide to early cure and control lower respiratory tract infection of aged patients effectively.