CAJ | 학술논문

目的：分析老年住院患者医院感染的流行病学及其耐药变迁，为临床治疗提供参考依据。方法收集2007年1月－2012年12月年龄＞60岁住院患者临床分离菌株1432株，采用微量稀释法进行药敏试验，采用SPSS17．0进行统计分析。结果临床分离菌株中呼吸道标本最多为1034株占72．2％；细菌培养送检阳性率69．53％，高于全院的61．58％；革兰阳性菌311株占21．7％，革兰阴性菌1121株占78．3％；耐甲氧西林金黄色葡萄球菌为31．8％，低于全院指标，产ESBLs大肠埃希菌为54．5％、产ESBLs肺炎克雷伯菌为46．7％，与全院指标相近；2007－2012年革兰阳性菌中葡萄球菌属和肠球菌属对抗菌药物的耐药性无明显变化；革兰阴性菌中肠杆菌科对碳青霉烯类保持高度敏感，其次为哌拉西林／他唑巴坦，而大肠埃希菌对头孢吡肟和头孢他啶的耐药率呈下降趋势。结论该项观察结果对于了解老年患者医院感染的流行病学特征、制定相应护理措施有一定的参考价值。
목적：분석노년주원환자의원감염적류행병학급기내약변천，위림상치료제공삼고의거。방법수집2007년1월－2012년12월년령＞60세주원환자림상분리균주1432주，채용미량희석법진행약민시험，채용SPSS17．0진행통계분석。결과림상분리균주중호흡도표본최다위1034주점72．2％；세균배양송검양성솔69．53％，고우전원적61．58％；혁란양성균311주점21．7％，혁란음성균1121주점78．3％；내갑양서림금황색포도구균위31．8％，저우전원지표，산ESBLs대장애희균위54．5％、산ESBLs폐염극뢰백균위46．7％，여전원지표상근；2007－2012년혁란양성균중포도구균속화장구균속대항균약물적내약성무명현변화；혁란음성균중장간균과대탄청매희류보지고도민감，기차위고랍서림／타서파탄，이대장애희균대두포필우화두포타정적내약솔정하강추세。결론해항관찰결과대우료해노년환자의원감염적류행병학특정、제정상응호리조시유일정적삼고개치。
OBJECTIVE To investigate the epidemiology and the changes in antibiotic resistance of isolates from hospitalized elderly patients so as to provide reference for clinical treatment .METHODS A total of 1 432 bacterial strains were isolated from elderly patients (≥60 years old) from Jan .2007 to Dec .2012 .Antimicrobial suscepti‐bility testing was done by micro‐dilution method . The software SPSS17 .0 was used for statistical analysis . RESULTS Among the bacterial strains ,most were from respiratory tract specimens (1 034 strains ,72 .2% ) .The positive rate of bacterial culture was 69 .53% in elderly patients ,higher than that of the whole hospital(61 .58% ) . There were 311 (21 .7% ) strains of gram‐positive bacteria and 1 121 (78 .3% ) strains of gram‐negative bacteria . Methicillin resistant Staphylococcus aureus (MRSA) accounted for 31 .8% ,lower than the overall limit of the hospital .Detection rates of ESBLs‐producing Escherichia coli and K lebsiella pneumoniae were 54 .5% and 46 .7% ,close to the overall limit of the hospital .The antimicrobial resistances of Staphylococcus and Enterococcus had no obvious changes in these years .The gram‐positive Enterobacteriaceae strains showed high sensitivity to carbopenems ,then to piperacillin/tazobactam .But the resistance rates of E .coli to cefepime and ceftazidime were decreasing gradually in the past years .CONCLUSION This observation is important and valuable for investigating epidemiology and making nursing measures in elderly patients .