摘要
目的:探讨老年急性呼吸衰竭(RF)合并肺部感染患者病原菌分布特点、耐药性及血清白介素-6(IL-6)、白介素-10(IL-10)水平变化的临床意义。方法:回顾性分析98例老年急性RF患者临床资料,依据是否并发肺部感染分为感染组(n=58)与未感染组(n=40),分析感染组病原菌分布、耐药性,并比较两组实验室指标数据。结果:感染组58例患者共培养病原菌67株,其中革兰阳性菌15株,占22.39%,革兰阴性菌48株,占71.64%,真菌4株,占5.97%。主要革兰阳性菌对红霉素、呋喃妥因、新诺明较敏感,主要革兰阴性菌对阿米卡星、头孢哌酮、亚胺培南较敏感。感染组血清IL-6、IL-10水平及肺部感染评分(CPIS)均高于未感染组,差异具有统计学意义(均P<0.05);经Spearman相关性分析,血清IL-6、IL-10水平与CPIS评分均呈正相关(均P<0.05)。结论:老年急性RF合并肺部感染患者病原菌主要为革兰阴性菌,且对抗菌药物具有一定耐药性,临床治疗时应依据药敏试验合理运用抗生素,且合并肺部感染患者血清IL-6、IL-8水平升高,临床可将上述指标作为疾病监测指标。
Objective:To investigate the distribution and drug resistance of pathogenic bacteria in elderly patients with acute respiratory failure(RF)complicated with pulmonary infection,and analyze the clinical significance of of changes in serum interleukin-6(IL-6)and interleukin-10(IL-10).Methods:The clinical data of 98 elderly patients with acute RF were reviewed.They were divided into infected group(n=58)and uninfected group(n=40)according to whether they were complicated with pulmonary infection.The distribution and drug resistance of pathogenic bacteria in the infected group were analyzed.Laboratory indicators were compared between groups.Results:A total of 67 pathogenic bacteria strains were obtained from the infected group,including 15(22.39%)strains of Gram-positive bacteria,48(71.64%)strains of Gram-negative bacteria and 4(5.97%)strains of fungi.The main Gram-positive bacteria were more sensitive to erythromycin,furantoin and sulfamethoxazole,while the main Gram-negative bacteria were more sensitive to amikacin,cefoperazone and imipenem.Serum IL-6 and IL-10 levels and the Clinical Pulmonary Infection Score(CPIS)in the infected group were higher than those in the uninfected group(all P<0.05).Spearman correlation analysis showed that serum IL-6 and IL-10levels were positively correlated with the CPIS score(all P<0.05).Conclusion:The pathogens in elderly patients with acute RF complicated with pulmonary infection are mainly Gram-negative bacteria,and they have a certain resistance to antibiotics.Antibiotics should be rationally used according to drug sensitivity test during clinical treatment.
作者
杜晶
张竹青
马春梅
李红永
DU Jing;ZHANG Zhuqing;MA Chunmei;LI Hongyong(Department of Infection,Western War Zone General Hospital,Chengdu 610083,China)
出处
《陕西医学杂志》
CAS
2023年第10期1354-1357,共4页
Shaanxi Medical Journal
基金
四川省自然科学基金资助项目(2023NSFSC0742)。
关键词
老年急性呼吸衰竭
肺部感染
病原菌分布
耐药性
白介素-6
白介素-10
Elderly acute respiratory failure
Pulmonary infection
Distribution of pathogenic bacteria
Drug resistance
Interleukin-6
Interleukin-10
