全国医院感染监控网老年患者医院感染病原菌及其耐药特征分析

目的探讨老年患者医院感染病原菌及其耐药性特征.方法对1999年7月～2002年6月全国医院感染监控网医院上报的老年患者医院感染病原菌进行统计分析.结果共计发生46 126例次老年患者医院感染,报告相应病原菌15 126株,阳性率为32.79%;病原菌以革兰阴性菌为主,占44.65%,其次为真菌、革兰阳性菌,分别为29.12%、25.92%,位于前3位的病原菌分别为其他真菌(14.36%)、白色念珠菌(12.33%)、铜绿假单胞菌(8.69%);除嗜麦芽寡养单胞菌以外,革兰阴性菌以亚胺培南最敏感,敏感率＞87%,对氨苄西林、阿莫西林、头孢唑林的耐药率＞51%,对头孢哌酮、哌拉西林的耐药率＞33%;阴沟肠杆菌和非发酵菌对头孢西丁的耐药率＞87%;MRSA和MRSE的检出率高达86.76%和76.32%.结论在老年患者医院感染病原菌中,真菌所占的比例高;细菌对抗菌药物的耐药性相当严重.

Pathogens Causing Nosocomial Infection in Senile Patients and Characteristics of Antimicrobial Resistance:Analysis of National Nosocomial Infection Surveillance System Data

OBJECTIVE To evaluate the patients causing nosocomial infection(NI) in senile patients and characteristics of antimicrobial resistance. METHODS Pathogens causing NI in senile patients reported to the National Nosocomial Infection Surveillance System from Jul 1997 to Jun 2002 were analyzed. RESULTS Totally(46 126 cases) of NI occurred,15 126 strains of pathogens were isolated,the positive rate was 32.79%;44.65% was(Gram-negative) bacteria,the isolation rate of fungi and Gram-positive bacteria was 29.12% and 25.92%,respectively.The top three pathogens were the fungi(14.36%),Candida albicans(12.33%) and Pseudomonas aeruginosa(8.69%);except Stenotrophomonas maltophilia Gram-negative bacteria had the highest susceptible rate(above 87%) to imipenem,the resistance rate to ampicillin,amoxycillin and cephazolin was above 51%,the resistance rate to cefoperazone and piperacillin was above 33%,the resistance rate of Enterobacter cloacae and nonfermenters to cefoxitin was above 87%,the isolation rate of MRSA and MRSE was up to 86.76% and 76.32%,respectively. CONCLUSIONS Fungi isolation is high among pathogens causing senile NI,and the bacterial resistance to antimicrobial agents is serious.