摘要
目的研究慢性肺源性心脏病(Chronic Pulmonary Heart Disease,CPHD)老年患者呼吸道感染病原菌及耐药情况。方法回顾性分析2012年10月-2016年10月医院收治的218例CPHD老年患者作为研究对象,对所有研究对象进行痰培养和药敏试验,对感染患者呼吸道病原菌及耐药情况进行分析。结果 218例患者感染149例,其中细菌感染112例;真菌感染37例,细菌感染例数多于真菌感染(P<0.001)。感染患者共培养分离病原菌348株,其中革兰阴性菌195株占56.03%,以铜绿假单胞菌、肺炎克雷伯菌为主;革兰阳性菌69株占19.83%,以金黄色葡萄球菌、溶血葡萄球菌为主。革兰阴性菌株数多于革兰阳性菌(P<0.001)。革兰阴性菌对多数抗菌药普遍耐药,铜绿假单胞菌对头孢哌酮较敏感;肺炎克雷伯菌对美罗培南及亚胺培南较敏感;鲍氏不动杆菌对头孢西丁、头孢哌酮、亚胺培南及美罗培南较为敏感;革兰阳性菌对多数抗菌药物耐药株数较多,尤其是红霉素及青霉素,但对万古霉素和利福平耐药株数较少。结论临床治疗CPHD老年呼吸道感染患者时应根据病原菌及药敏分析,针对性根据所感染的病原菌进行抗菌药物的使用,防止滥用抗菌药物造成难治性感染的出现。
OBJECTIVE To study the pathogenic bacteria and drug resistance of respiratory tract infections in the elderly patients with chronic pulmonary heart disease（CPHD）.METHODS A total of 218 cases of elderly patients with CPHD in the hospital from Oct.2012 to Oct.2016 were retrospectively analyzed.All the subjects were taken sputum culture and drug sensitivity test,and the respiratory tract infection pathogens and drug resistance were analyzed.RESULTS Totally 149 cases were infected among 218 patients,of which 112 cases were bacterial infection and 37 cases were fungal infections.The rate of bacterial infections was significantly higher than that of fungal infection（P〈0.001）.A total of 348 pathogens were isolated from infected patients,of which 195 strains were gram-negative bacteria,accounting for 56.03%,mainly Pseudomonas aeruginosaand Klebsiella pneumoniae,and69 strains were gram-positive bacteria,accounting for 19.83%,mainly Staphylococcus aureus and Staphylococcus haemolysin.Gram-negative bacteria were more than gram-positive bacteria（P〈0.001）.Gram-negative bacteria were generally resistant to most antibacterial agents.P.aeruginosa was sensitive to cefoperazone,K.pneumoniae was sensitive to meropenem and imipenem,and A.baumannii was sensitive to cefoxitin,cefoperazone,imipenem and meropenem.Gram-positive bacteria were resistant to most antibiotics,especially erythromycin and penicillin,but they were sensitive to vancomycin and rifampicin.CONCLUSIONIn the treatment of respiratory tract infections in elderly patients with CPHD,we should analyze the species of pathogenic bacteria according to drug sensitivity test,and use antibiotics according to the pathogenic bacteria to prevent the occurrence of refractory infections.
作者
胡良英
苏美霞
蒋景华
李明晖
HU Liang-ying;SU Mei-xia;JIANG Jing-hua;LI Ming-hui(Shaoxing People＇s Hospital of Zhejiang, Shaoxing, Zhejiang 312000, China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2018年第11期1650-1653,共4页
Chinese Journal of Nosocomiology
