老年下呼吸道感染病原菌分布和耐药性研究

目的了解老年患者下呼吸道感染病原菌的分布及耐药情况,为预防和治疗老年下呼吸道感染提供依据。方法采用法国生物梅里埃ATB药物敏感(药敏)鉴定系统软件,统计分析88例老年患者下呼吸道标本分离菌种类及药敏结果,同时用酶联免疫吸附法进行肺炎支原体、肺炎衣原体、呼吸道合胞病毒、腺病毒血清抗体检测。结果检测出老年下呼吸道感染病原菌70株,其中革兰阴性菌50株(71.4%),包括肺炎克雷伯菌肺炎亚种21株(30.0%)、鲍氏不动杆菌16株(22.9%)、大肠埃希菌13株(18.6%)。革兰阳性菌主要为金黄色葡萄球菌12株(17.1%)。血清抗体检测发现呼吸道合胞病毒28株(45.2%),肺炎支原体17株(27.4%),肺炎衣原体8株(12.9%)等。引起老年下呼吸道感染的金黄色葡萄球菌除对青霉素不敏感外,对大多数抗生素还是敏感的。革兰阴性菌对头孢类抗生素敏感,对其他抗生素相对不敏感。结论多种因素可引起老年下呼吸道感染且病原菌复杂。临床应根据实际情况采取措施并根据检测结果合理使用抗生素以控制疾病和防止产生耐药菌。

Pathogen distribution and drug resistance in elderly patient with lower respiratory tract infection

Objective To evaluate the distribution and drug resistance of pathogen of elderly lower respiratory infection patient,and to provide evidence for clinic prevention and cure elderly infection.Methods France bioMérieux ATB system software was used statistical analysis of 88 cases of elderly patients with type strains isolated from respiratory tract and sensitivity results.Mycoplasma pneumoniae,Chlamydia pneumoniae,respiratory syncytial virus and adenovirus antibody were detected by enzyme-linked immunosorbent assay in the patients.Results Seventy strains of bacteria were isolated in this group,in which gram-negative bacterium were 50 strains（71.4%）,including 21 strains of Klebsiella pneumoniae subspecies pneumoniae（30.0%）,16 strains of Acinetobacter baumannii（22.9%） and 13 strains of Escherichia coli（18.6%）.Gram-positive bacterium were 12 strains of Staphylococcus aureus（17.1%）,etc.Serum antibodies were detected 28 strains of respiratory syncytial virus（45.2%）,17 Mycoplasma pneumoniae strains（27.4%）,and 8 pneumonia chlamydia（12.9%）,etc.Lower respiratory tract infection caused by the elderly of Staphylococcus aureus and 12 strains not sensitive to penicillin in addition to,but still sensitive to most antibiotics.Gram-negative bacteria were sensitive to cephalosporins antibiotics,relatively insensitive to other antibiotics.Conclusion A variety of factors can cause respiratory tract infection of elderly,and the pathogen complex.In clinical practice,measures are taken based on the actual situation and the rational use of antibiotics based on test results to control the disease and prevent drug-resistant.