中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2009年
11期
63-64
,共2页
下呼吸道%革兰阴性杆菌%耐药%老年人
下呼吸道%革蘭陰性桿菌%耐藥%老年人
하호흡도%혁란음성간균%내약%노년인
Lower respiratorry tracts%Gram-Negative bacillus%Druyg tolerance%Elderly patients
目的 了解老年人下呼吸道感染革兰阴性(G-)杆菌的分布及药敏情况,为临床用药提供依据.方法 对2006年3月至2008年6月期问在住院的老年人下呼吸道感染患者痰液标本中分离到937株G.杆菌,采用Microscan Walk Away仪进行鉴定和药敏试验,所得结果进行统计分析.结果 G-杆菌中分离率最高的前三种是大肠埃希氏菌(36.6%)、肺炎克雷氏菌(19.7%)和铜绿假单胞菌(17.0%).它们产ESBLS分离率分别是48.4%、61.2%和32.1%.大肠埃希氏茵和肺炎克雷伯菌对亚胺培南和丁胺卡那敏感率最高,分别是100%和88.4%～91.3%,对头孢类、磺胺类和青霉类抗生素均有不同程度的下降.铜绿假单胞菌对各种抗生素敏感率低,哌拉西林/他巴唑坦也仅在76.8%,对阿莫西林/克拉维酸与头孢噻肟的敏感率最低,均仅3.2%,其次是头孢曲松,为12.3%.结论 老年人下呼吸道感染革兰氏性杆菌ESBLS检出率高,对各种抗生素敏感率低,且呈多重性耐药性,应引起临床关注.
目的 瞭解老年人下呼吸道感染革蘭陰性(G-)桿菌的分佈及藥敏情況,為臨床用藥提供依據.方法 對2006年3月至2008年6月期問在住院的老年人下呼吸道感染患者痰液標本中分離到937株G.桿菌,採用Microscan Walk Away儀進行鑒定和藥敏試驗,所得結果進行統計分析.結果 G-桿菌中分離率最高的前三種是大腸埃希氏菌(36.6%)、肺炎剋雷氏菌(19.7%)和銅綠假單胞菌(17.0%).它們產ESBLS分離率分彆是48.4%、61.2%和32.1%.大腸埃希氏茵和肺炎剋雷伯菌對亞胺培南和丁胺卡那敏感率最高,分彆是100%和88.4%～91.3%,對頭孢類、磺胺類和青黴類抗生素均有不同程度的下降.銅綠假單胞菌對各種抗生素敏感率低,哌拉西林/他巴唑坦也僅在76.8%,對阿莫西林/剋拉維痠與頭孢噻肟的敏感率最低,均僅3.2%,其次是頭孢麯鬆,為12.3%.結論 老年人下呼吸道感染革蘭氏性桿菌ESBLS檢齣率高,對各種抗生素敏感率低,且呈多重性耐藥性,應引起臨床關註.
목적 료해노년인하호흡도감염혁란음성(G-)간균적분포급약민정황,위림상용약제공의거.방법 대2006년3월지2008년6월기문재주원적노년인하호흡도감염환자담액표본중분리도937주G.간균,채용Microscan Walk Away의진행감정화약민시험,소득결과진행통계분석.결과 G-간균중분리솔최고적전삼충시대장애희씨균(36.6%)、폐염극뢰씨균(19.7%)화동록가단포균(17.0%).타문산ESBLS분리솔분별시48.4%、61.2%화32.1%.대장애희씨인화폐염극뢰백균대아알배남화정알잡나민감솔최고,분별시100%화88.4%～91.3%,대두포류、광알류화청매류항생소균유불동정도적하강.동록가단포균대각충항생소민감솔저,고랍서림/타파서탄야부재76.8%,대아막서림/극랍유산여두포새우적민감솔최저,균부3.2%,기차시두포곡송,위12.3%.결론 노년인하호흡도감염혁란씨성간균ESBLS검출솔고,대각충항생소민감솔저,차정다중성내약성,응인기림상관주.
Objective To study drug resistance and distribution of infectious gram-negative bacillus in lower respiratory tract of elderly patients to use the experience for reference of clinical apphcation.Methods 937 strains of gram-negative bacillus isolated from the qualified sputum sample of elderly patients who were admitted from March 2006 to June 2008 were done.The drug sensitivity tests were done for the positive bacterium bv the GNS-NT cards of bacterium inspection and the drug resistance was measured with Microscan Walk Away.All data was analyzed at lsat.Results The 3 most common isolated gram-negative bacillus were Bacillus coil (36.6%),Klebsiella pneumoniae(19.7%),and Bacillus pyocyaneus(17.0%),the detection rates of the producing ESBLs were 48.4%,61.2%.32.1%respectively.The drug resistances of Bacillus coli and Klebsiella pneumoniae for cephalosporins,sulfonamides,and penicillins antibiotics were all elevated,except that for Imipenem,and Amikacin.The drug-sensitivity rates were 100%,88.4%～91.3%respectively.Bacillus pyocyaneus had the higher drug-sensitivity rates of 76.8%for Pip/Tazo,drug-sensitivity rate of Bacillus pyocyaneus to Amox/K Clay(3.2%)and Ceftriaxone(12.3%)was significantly lower than another antibiotics.Conclusion Gram-negative bacilli have become the major pathogens in lower respiratory tract infections had the higher ratio of producing ESBLs and lower drug-sensitivity with high multidrug resistance..We should select the antibiotic according to the results of drug sensitivity teat.
