老年患者下呼吸道感染细菌分布及耐药性监测

目的对老年患者下呼吸道感染细菌分布及耐药性进行监测分析,为临床合理用药提供依据。方法采集医院2003年1月-2005年6月期间,老年下呼吸道感染患者的痰标本,进行菌株鉴定和药敏试验,按NCCLS标准判断。结果752株细菌中,革兰阴性杆菌占70.90%,革兰阳性球菌占17.60%;细菌学培养阳性前5位：肺炎克雷伯菌（ESBLs27.70%）占14.89%,铜绿假单胞菌占14.36%,大肠埃希菌（ESBLs35.40%）占12.77%,金黄色葡萄球菌（MRSA59.00%）占11.70%,真菌占11.57%。结论老年患者下呼吸道感染细菌分布较广泛,革兰阳性球菌中,只有万古霉素未发现耐药菌株,革兰阴性杆菌中,亚胺培南敏感率最高,但存在耐药菌株。

Distribution and Resistance of Bacteria from Lower Respiratory Tract Infection in Elderly Patients

OBJECTIVE To analyze distribution and resistance of bacteria from lower respiratory tract infection in elderly patients,and provide reference for rationl use of agents in clinics.METHODS To collect phlegm specimens from lower respiratory tract infection in elderly patients from Jan 2003 to Jun 2005 in our hospital,to identify pathogens and drug sensitivity test,the results of examination were judged according to NCCLS standard.RESULTS Among 752 pathogens strains,Gram-negative bacteria and Gram-positive cocci were 70.9% and 17.6%,respectively;the most common pathogens of them were Klebsiella pneumoniae(ESBLs 27.7%)14.89%,Pseudomonas aeruginosa 14.36%,Escherichia coli(ESBLs 35.4%)12.77%,Staphylococcus aureus(MRSA 59.0%)11.70%,and fungi 11.57%.CONCLUSIONS The bacteria from lower respiratory tract infection in elderly patients are distributed extensively.In Gram-positive cocci,resistance to vancomycin is not found elsely.Gram-negative bacteria are especially sensitive to imipenem,but with some resistant strains.