老年支气管扩张合并急性感染的病原菌及其耐药性研究

目的:了解老年支气管扩张患者急性感染的病原学分布及药敏情况,指导临床抗菌药物的使用。方法:对2000—2012年本院呼吸科104份老年支气管扩张急性感染患者的痰标本进行细菌培养及药敏试验。结果:150例痰标本分离出致病菌107株,其中革兰氏阴性菌87株,占81%,排在前3位的致病菌分别是铜绿假单胞菌(35%),肺炎克雷伯菌(14%),鲍曼不动杆菌(11%)。革兰氏阳性球菌8株(7%),真菌12株(11%)。药敏实验显示所分离出的革兰氏阴性杆菌对哌拉西林-他唑巴坦,第3、4代头孢菌素及碳青霉烯类、多粘菌素等抗菌药物敏感性较高。结论:老年支气管扩张急性感染的病原菌分布以革兰氏阴性杆菌为主,铜绿假单胞菌排在首位,经验治疗时建议选用哌拉西林/他唑巴坦、头孢三代、四代或碳青霉烯类药物。

Pathogens and drug resistant rate analysis of aged of bronchiectasis patients in an acute exacerbation

AIM:To learn the situation of pathogens distribution and drug sensitivity in aged bronchiectasis in an acute exacerbation.METHODS: 150 samples of sputum bacteria culture and drug sensitivity tests from 104 aged patients were performed in our hospital from 2000 to 2012.RESULTS:107 isolates isolated from 150 sputum samples,among them there were 87 isolates of gram-negative bacillus(81%).The most common Gram-negative bacillus isolated were Pseudomonas aeruginosa(35%),Klebsiella pneumoniae(14%),Acinetobacter baumannii(11%).There were 8 strains of gram-positive bacteria(7%),12 strains of fungi(11%).Piperacillin/tabazotani,three generation cephalosporin,four generation cephalosporin carbapenem,and quinolone has better antimicrobial activity against.gram-negative bacillus.CONCLUSION: The main pathogen of aged bronchiectasis in an acute exacerbation was gram negative bacteria,pseudomonas aeruginosa was the most commen pathogens among them.Piperacillin/tabazotani,three generation cephalosporin,four generation cephalosporin,carbapenem should be recommended to treat these aged bronchiectasis patients.