| 褚月娇,周楚铭,韩莹莹,等.呼吸科病房老年病人肺部感染常见病原菌及其耐药性分析[J].安徽医药,2019,23(1):63-66. |
| 呼吸科病房老年病人肺部感染常见病原菌及其耐药性分析 |
| Pathogen distribution and drug resistance in elderly patients with pulmonary infection in the department of respiratory |
| 投稿时间：2017-03-22 |
| DOI： |
| 中文关键词: 呼吸道感染 抗药性,细菌 抗药性,真菌 革兰阳性菌感染 革兰阴性菌感染 病房 老年人 |
| 英文关键词: Respiratory tract infections Drug resistance,bacterial Drug resistance,fungal Gram-positive bacterial infections Gram-negative bacterial infections Patients' rooms Aged |
| 基金项目:国家自然科学基金(81101224) 呼吸科病房老年病人肺部感染常见病原菌及其耐药性分析褚月娇1,周楚铭3,韩莹莹2,刘丹1,万小旭1,王佳贺1 (1.中国医科大学附属盛京医院,老年病科,辽宁 沈阳 110004；3.中国医科大学附属盛京医院呼吸科,辽宁 沈阳 110004；2.吉林大学中日联谊医院神经内三科,吉林 长春 130033) |
| 作者 | 单位 | E-mail | | 褚月娇 | 中国医科大学附属盛京医院,老年病科,辽宁 沈阳 110004 | | | 周楚铭 | 中国医科大学附属盛京医院呼吸科,辽宁 沈阳 110004 | | | 韩莹莹 | 吉林大学中日联谊医院神经内三科,吉林 长春 130033 | | | 刘丹 | 中国医科大学附属盛京医院,老年病科,辽宁 沈阳 110004 | | | 万小旭 | 中国医科大学附属盛京医院,老年病科,辽宁 沈阳 110004 | | | 王佳贺 | 中国医科大学附属盛京医院,老年病科,辽宁 沈阳 110004 | wangjhcmusj@163.com |
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| 中文摘要: |
| 目的 对老年病人(年龄≥65岁)肺部感染的常见病原菌及其耐药性进行分析,为临床预防和治疗老年肺部感染提供依据。方法 回顾性收集中国医科大学附属盛京医院2013年1月至2015年12月老年病人感染的常见病原菌并对其耐药性进行分析。结果 共分离出318株病原菌,其中革兰阴性杆菌295例,占92.77%。其中鲍曼不动杆菌最多,占43.71%；其次是铜绿假单胞菌和肺炎克雷伯杆菌,分别占16.98%和12.89%。共分离出革兰阳性球菌20例,占6.29%。真菌3例,占0.94%。不同病原菌耐药程度不同,其中鲍曼不动杆菌对青霉素类、头孢类抗生素耐药率达90%~100%,对氨基糖苷类抗生素耐药率亦达38%~90%,仅替加环素耐药率为10.31%。铜绿假单胞菌耐药亦较严重。肺炎克雷伯杆菌耐药率相对乐观,临床可选药物较多。金黄色葡萄球菌对青霉素、头孢类抗生素几乎均耐药,对万古霉素、利奈唑胺、喹努普汀/达福普汀及替加环素最为敏感。结论 老年肺部感染以革兰阴性杆菌为主,临床应根据药敏实验结果合理应用抗生素来更好地控制疾病和防止产生耐药菌。 |
| 英文摘要: |
| Objective To provide firm evidence for prevention and treatment of pulmonary infection,we conducted a study to investigate the pathogen distribution and drug resistance in hospitalized elderly patients with pulmonary infection.Methods Data about common pathogens and antimicrobial resistance were collected and retrospectively analyzed in patients who were hospitalized for pulmonary infection from January 2013 to December 2015 in our hospital.Results Among the isolated 318 strains of pathogenic bacteria,295 (92.77%) were gram-negative bacilli.Acinetobacter baumannii,which is the most common gram-negative bacilli,accounts for 43.71% of the total pathogens,followed by Pseudomonas aeruginosa and Klebsiella pneumoniae,making up 16.98% and 12.89% respectively of the total isolated pathogens.20 gram-positive cocci and 3 Fungi in 318 strains of isolated pathogens,accounting for 6.29% and 0.94% respectively.The degree of resistance are different between different pathogens.The resistant rate of Baumannii to penicillin and cephalosporins is up to 90%-100%,to aminoglycosides is 38%-90%,while to tigecycline is only 10.31%.Drug-resistance of Pseudomonas aeruginosa is severe as well,but resistance of Klebsiella bacillus is less severe,with more effective antibiotics available for clinical use.Staphylococcus aureus is almost resistant to penicillin and cephalosporins,while sensitive to vancomycin,linezolid,quinupristin/dalfopristin and tigecycline.Conclusion Gram-negative bacilli are the main pathogens of pulmonary infection in the elderly patients.To effectively control infection and prevent the emergence of drug resistance,antibiotics should be reasonably selected according to drug-sensitive test. |
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