老年患者下呼吸道医院感染病原菌分类和耐药性分析.docVIP

老年患者下呼吸道医院感染病原菌分类和耐药性分析 　　[摘要] 目的 探讨老年患者下呼吸道医院感染病原菌的分类与耐药性。 方法 整群选取2015年1月―2016年10月该院收治的呼吸道医院感染的759例老年患者为研究对象，提取患者咽喉深部痰液进行病原菌培养及药敏试验，观察病原菌种类及革兰阴性菌对抗菌药物的耐药性。 结果 759例样本共分离菌株986株，其中铜绿假单胞菌275株（27.89%），肺炎克雷伯菌211株（21.40%），白假丝酵母菌148株（15.01%），大肠埃希菌123株（12.47%），金黄色葡萄球菌123株（11.16%），鲍曼不动杆菌99株（10.04%），其他20株（2.03%）。革兰阴性菌对头孢克肟、庆大霉素、左氧氟沙星、头孢他啶耐药率较高，普遍超过40.00%，对阿米卡星、哌拉西林、亚胺培南和头孢哌酮的耐药性则相对较低，小于20.00%。 结论 老年下呼吸道医院感染病原菌种类多，耐药性普遍较为严重，临床应根据药敏结果合理选择抗菌药物以减少耐药菌株产生，提高治疗效果。 　　[关键词] 老年；下呼吸道感染；医院感染；病原菌；耐药性 　　[中图分类号] R446 [文献标识码] A [文章编号] 1674-0742（2017）02（b）-0073-03 　　[Abstract] Objective To discuss the lower respiratory tract hospital infection pathogenic bacteria classification and tolerance. Methods 759 cases of senile patients with respiratory tract hospital infection from January 2015 to October 2016 were group selected as the research objects and the sputum in deep throat of patients was extracted for pathogenic bacteria culture and drug sensitivity test， and the pathogenic bacteria type and tolerance of gram-negative bacteria to antibacterials were observed. Results 986 strains were isolated from 759 cases of samples， accounting for 275 strains of pseudomonas aeruginosa（27.89%）， 211 strains of klebsiella pneumoniae （21.40%）， 148 strains of candida albicans （15.01%）， 123 strains of E.coli （12.47%）， 123 strains of staphylococcus aureus（11.16%）， 99 strains of baumanii （10.04%）and other strains （2.03%）， and the tolerance of gram-negative bacteria to cefixime， gentamicin， levofloxacin and ceftazidime was higher， more than 40.00%， and the tolerance to amikacin， piperacillin， imipenem and cefoperazone was relatively low， less than 20.00%. Conclusion The type of lower respiratory tract hospital infection pathogenic bacteria is more， and the tolerance is severe in common， and in clinic， we should rationally select the antibacterials according to the drug sensitive Results in order to reduce the development of drug resistant strains and improve the treatment effect. 　　[Key words] Senile； Low