3530株老年患者分离病原菌种类及耐药性分析

目的了解老年患者分离病原菌种类及耐药性,为合理用药提供依据。方法细菌鉴定和药敏试验主要采用Phoenix100分析仪,念珠菌鉴定采用显色平板法,药敏试验采用K-B法。数据分析采用WHONET5.6软件。结果老年患者分离病原菌中最常见的为大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、白色念珠菌、粪肠球菌和屎肠球菌。大肠埃希菌和肺炎克雷伯菌超广谱β内酰胺酶产酶率分别为54.3%和50.5%。金黄色葡萄球菌、溶血葡萄球菌和表皮葡萄球菌甲氧西林耐药率分别为59.5%、93.2%和86.9%。革兰阴性杆菌对亚胺培南、美罗培南、阿米卡星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦耐药率较低。革兰阳性球菌对万古霉素、替考拉宁和利奈唑胺的敏感率均为100.0%。念珠菌对临床常用抗菌药物耐药率均低于5.0%。结论本院老年患者分离病原菌耐药率较高,应重视临床合理用药以降低耐药率。

Distribution and antibiotic resistance analysis of 3 530 pathogen isolated from elder patients

Objective To investigate distribution and drug resistance of bacteria and fungi isolated from elder patients.Methods Most bacteria isolates were identified with Phoenix100 analyzer.Candida isolates were identified by color display plate and by K-B method.WHONET5.6 was applied for data analysis.Results The common isolates from elder patients were E.coli,A.baumannii,P.aeruginosa,K.pneumoniae,S.aureu,C.albicans,E.faecalis,and E.faecium.The incidences of E.coli and K.pneumoniae isolates producing extended spectrum beta-lactamase（ESBLs） were 54.3% and 50.5% respectively.The meticillin resistant rates of S.aureu,S.haemolyticus and S.epidermidis were 59.5%,93.2% and 86.9% respectively.In gram negative bacillus,lower resistant rates of antibiotics were Imipenem,Meropenem,Amikacin,Cefoperazone/Sulbactam,and Piperacillin/Tazobactam.In gram positive coccus,susceptible rates of Vancomycin,Teicoplanin and Linezolid were 100.0%.In Candida isolates,resistant rates of common drug were below 5.0%.Conclusion Resistant rates of pathogen isolated from elder patients secretion in this hospital might be high.It is important to enforce the rational use of antimicrobial agents to reduce resistant rates of bacteria.