中国医药科学
中國醫藥科學
중국의약과학
CHINA MEDICINE AND PHARMACY
2013年
15期
179-180,188
,共3页
老年%肺部感染%病原菌%类型%耐药性
老年%肺部感染%病原菌%類型%耐藥性
노년%폐부감염%병원균%류형%내약성
Elderly%Pulmonary infection%Pathogens%Types%Drug resistance
目的分析老年肺部感染患者病原菌类型及耐药性。方法选取我院2010年10月~2012年8月收治老年肺部感染患者120例，其中合并慢性阻塞性肺疾病者75例，设为A组，未合并慢性阻塞性肺疾病者45例，设为B组，均探讨行痰细菌学培养和药物敏感试验，分析患者病原菌感染类型，比较两组患者抗生素耐药率，治愈率及死亡率等。结果老年肺部感染患者以革兰阴性菌感染为主，A组和B组分别占总感染人数86.6%，78.2%，其中铜绿假单胞菌，肺炎克雷伯菌及假单胞菌均居于感染百分比前3位；B组患者肺炎链球菌感染率明显高于A组，组间比较差异有统计学意义（P＜0.05）；A组患者头孢噻肟、头孢唑林及头孢哌酮耐药率分别为53.3%，58.7%，54.7%；B组患者头孢噻肟、头孢唑林及头孢哌酮耐药率分别为35.6%，40.0%，37.8%；A组患者头孢噻肟、头孢唑林及头孢哌酮耐药率均明显高于B组，组间比较差异有统计学意义（P＜0.05）；A组患者治愈率及死亡率分别为57.3%，9.3%；B组患者的治愈率及死亡率分别为75.6%，2.2%；A组患者治愈率及死亡率均明显高于B组，组间比较差异有统计学意义（P＜0.05）。结论老年肺部感染患者病原菌以革兰阴性菌为主，合并COPD患者细菌耐药较严重；临床治疗应当注重合理应用抗生素，以有效降低死亡率，改善预后。
目的分析老年肺部感染患者病原菌類型及耐藥性。方法選取我院2010年10月~2012年8月收治老年肺部感染患者120例，其中閤併慢性阻塞性肺疾病者75例，設為A組，未閤併慢性阻塞性肺疾病者45例，設為B組，均探討行痰細菌學培養和藥物敏感試驗，分析患者病原菌感染類型，比較兩組患者抗生素耐藥率，治愈率及死亡率等。結果老年肺部感染患者以革蘭陰性菌感染為主，A組和B組分彆佔總感染人數86.6%，78.2%，其中銅綠假單胞菌，肺炎剋雷伯菌及假單胞菌均居于感染百分比前3位；B組患者肺炎鏈毬菌感染率明顯高于A組，組間比較差異有統計學意義（P＜0.05）；A組患者頭孢噻肟、頭孢唑林及頭孢哌酮耐藥率分彆為53.3%，58.7%，54.7%；B組患者頭孢噻肟、頭孢唑林及頭孢哌酮耐藥率分彆為35.6%，40.0%，37.8%；A組患者頭孢噻肟、頭孢唑林及頭孢哌酮耐藥率均明顯高于B組，組間比較差異有統計學意義（P＜0.05）；A組患者治愈率及死亡率分彆為57.3%，9.3%；B組患者的治愈率及死亡率分彆為75.6%，2.2%；A組患者治愈率及死亡率均明顯高于B組，組間比較差異有統計學意義（P＜0.05）。結論老年肺部感染患者病原菌以革蘭陰性菌為主，閤併COPD患者細菌耐藥較嚴重；臨床治療應噹註重閤理應用抗生素，以有效降低死亡率，改善預後。
목적분석노년폐부감염환자병원균류형급내약성。방법선취아원2010년10월~2012년8월수치노년폐부감염환자120례，기중합병만성조새성폐질병자75례，설위A조，미합병만성조새성폐질병자45례，설위B조，균탐토행담세균학배양화약물민감시험，분석환자병원균감염류형，비교량조환자항생소내약솔，치유솔급사망솔등。결과노년폐부감염환자이혁란음성균감염위주，A조화B조분별점총감염인수86.6%，78.2%，기중동록가단포균，폐염극뢰백균급가단포균균거우감염백분비전3위；B조환자폐염련구균감염솔명현고우A조，조간비교차이유통계학의의（P＜0.05）；A조환자두포새우、두포서림급두포고동내약솔분별위53.3%，58.7%，54.7%；B조환자두포새우、두포서림급두포고동내약솔분별위35.6%，40.0%，37.8%；A조환자두포새우、두포서림급두포고동내약솔균명현고우B조，조간비교차이유통계학의의（P＜0.05）；A조환자치유솔급사망솔분별위57.3%，9.3%；B조환자적치유솔급사망솔분별위75.6%，2.2%；A조환자치유솔급사망솔균명현고우B조，조간비교차이유통계학의의（P＜0.05）。결론노년폐부감염환자병원균이혁란음성균위주，합병COPD환자세균내약교엄중；림상치료응당주중합리응용항생소，이유효강저사망솔，개선예후。
Objective To analyze the types and drug resistance of pathogens of the elderly patients with pulmonary infection. Methods 120 elderly patients with pulmonary infection treated in our hospital from October 2010 to August 2012 were selected,of which 75 patients complicated by chronic obstructive pulmonary disease were established as group A and 45 patients not complicated by chronic obstructive pulmonary disease were established as group B.All the patients received sputum bacteriological culture and drug susceptibility test.The pathogen types of patients were analyzed and the antibiotics drug resistance rate,cure rate and mortality of the two groups of patients were compared. Results Gram-negative bacteria were the main pathogens of elderly pulmonary infection,which accounted for 86.6%and 78.2%of the total infected persons of group A and group B respectively,of which Pseudomonas aeruginosa, Klebsiella pneumoniae and Pseudomonas ranked the top three of infection percentage.Group B was higher than group A in the Streptococcus pneumoniae infection rate,with statistical between-group difference(P<0.05).The drug resistance rates of cefotaxime,cefazolin and cefoperazone of group A were 53.3%,58.7% and 54.7% and those of group B were 35.6%,40.0%and 37.8%;Group A was significantly higher than group B in all the drug resistance rates of cefotaxime, cefazolin and cefoperazone,with statistically significant between-group differences(P < 0.05).The cure rate and mortality of group A were 57.3%and 9.3%respectively and those of group B were 75.6%and 2.2%respectively;Group A was significantly higher than group B in both cure rate and mortality,with statistically significant between-group differences (P<0.05). Conclusion The major pathogens of elderly pulmonary infection were gram-negative bacteria and the patients complicated by COPD had more severe bacteria drug resistance.Clinical treatment should pay attention to the rational usage of antibiotics in order to effectively reduce mortality and improve prognosis.
