中国老年保健医学
中國老年保健醫學
중국노년보건의학
CHINESE JOURNAL OF GERIATRIC CARE
2015年
3期
9-13
,共5页
刘振丽%隋小芳%刘艳%胡依粉
劉振麗%隋小芳%劉豔%鬍依粉
류진려%수소방%류염%호의분
支气管扩张%老年人%病原菌%耐药性
支氣管擴張%老年人%病原菌%耐藥性
지기관확장%노년인%병원균%내약성
bronchiectasis%the elderly%pathogenic bacteria%drug resistance
目的：调查老年人支气管扩张患者中病原菌的分布及其耐药性的现状，为临床治疗提供参考依据。方法对329例老年支气管扩张患者的痰液病原菌分离鉴定和药物敏感性试验进行回顾性调查。结果329例患者242例呈病原菌感染阳性，阳性率为73.56％。共分离出致病菌431株，其中鉴定出20种病原菌，以革兰氏阴性菌为主，占73.78％（318株），革兰氏阳性菌和真菌分别为57株（13.23％）和56株（12.99％）。革兰氏阴性菌主要为肺炎克雷伯杆菌和铜绿假单胞菌。革兰氏阴性菌中分离率较高的肺炎克雷伯杆菌、铜绿假单胞菌、大肠杆菌、嗜麦芽假单胞菌、鲍曼不动杆菌、流感嗜血杆菌和副流感嗜血杆菌对亚胺培南和美罗培南的敏感性较高，对其余抗菌药物都表现出一定的耐药率。革兰氏阳性菌对青霉素、阿莫西林、阿奇霉素、克林霉素、复方新诺明和环丙沙星表现出较高的耐药率，而对利福平、四环素、替考拉宁、万古霉素和利奈唑胺具有较高的敏感性。结论老年支气管扩张患者病原菌以革兰氏阴性菌为主，且病原菌耐药率高，因此临床使用抗菌药物治疗，应针对患者的病原菌的分布及其耐药性的特征进行。
目的：調查老年人支氣管擴張患者中病原菌的分佈及其耐藥性的現狀，為臨床治療提供參攷依據。方法對329例老年支氣管擴張患者的痰液病原菌分離鑒定和藥物敏感性試驗進行迴顧性調查。結果329例患者242例呈病原菌感染暘性，暘性率為73.56％。共分離齣緻病菌431株，其中鑒定齣20種病原菌，以革蘭氏陰性菌為主，佔73.78％（318株），革蘭氏暘性菌和真菌分彆為57株（13.23％）和56株（12.99％）。革蘭氏陰性菌主要為肺炎剋雷伯桿菌和銅綠假單胞菌。革蘭氏陰性菌中分離率較高的肺炎剋雷伯桿菌、銅綠假單胞菌、大腸桿菌、嗜麥芽假單胞菌、鮑曼不動桿菌、流感嗜血桿菌和副流感嗜血桿菌對亞胺培南和美囉培南的敏感性較高，對其餘抗菌藥物都錶現齣一定的耐藥率。革蘭氏暘性菌對青黴素、阿莫西林、阿奇黴素、剋林黴素、複方新諾明和環丙沙星錶現齣較高的耐藥率，而對利福平、四環素、替攷拉寧、萬古黴素和利奈唑胺具有較高的敏感性。結論老年支氣管擴張患者病原菌以革蘭氏陰性菌為主，且病原菌耐藥率高，因此臨床使用抗菌藥物治療，應針對患者的病原菌的分佈及其耐藥性的特徵進行。
목적：조사노년인지기관확장환자중병원균적분포급기내약성적현상，위림상치료제공삼고의거。방법대329례노년지기관확장환자적담액병원균분리감정화약물민감성시험진행회고성조사。결과329례환자242례정병원균감염양성，양성솔위73.56％。공분리출치병균431주，기중감정출20충병원균，이혁란씨음성균위주，점73.78％（318주），혁란씨양성균화진균분별위57주（13.23％）화56주（12.99％）。혁란씨음성균주요위폐염극뢰백간균화동록가단포균。혁란씨음성균중분리솔교고적폐염극뢰백간균、동록가단포균、대장간균、기맥아가단포균、포만불동간균、류감기혈간균화부류감기혈간균대아알배남화미라배남적민감성교고，대기여항균약물도표현출일정적내약솔。혁란씨양성균대청매소、아막서림、아기매소、극림매소、복방신낙명화배병사성표현출교고적내약솔，이대리복평、사배소、체고랍저、만고매소화리내서알구유교고적민감성。결론노년지기관확장환자병원균이혁란씨음성균위주，차병원균내약솔고，인차림상사용항균약물치료，응침대환자적병원균적분포급기내약성적특정진행。
Objectives Survey of the elderly patients with bronchiectasis pathogenic bacteria distribution and drug resistance sit-uation, provide reference for clinical treatment.Methods In 329 cases of elderly patients with bronchiectasis pathogens isolated from sputum and drug sensitivity test were retrospectively investigation.Results 329 patients, 242 cases of pathogenic bacteria in-fection is positive, positive rate was 73.56%.A total of 431 strains pathogenic bacteria isolated, identified 20 kinds of pathogenic bacteria, mainly gram-negative bacteria, 73.78% ( 318 strains ) , gram positive bacteria and fungi, respectively 57 strains (13.23%) and 56 strains (12.99%).Gram-negative bacteria are mainly with klebsiella pneumoniae and pseudomonas aerugino-sa.High separation rate of gram-negative bacteria with klebsiella pneumoniae, pseudomonas aeruginosa, escherichia coli, eosinophil-ic malt pseudomonas, acinetobacter baumannii, haemophilus influenzae and the imine with haemophilus culture of the south and e-.faecalis sensitivity high, show a certain percentages of antibacterial drugs for the rest.Gram positive bacteria to penicillin, amoxicil-lin, azithromycin and clindamycin, compound ciprofloxacin new Ming and showed high resistance, and to rifampin, tetracycline, teicoplanin, vancomycin and rina thiazole amine has higher sensitivity.Conclusions In elderly patients with bronchiectasis patho-gen is given priority to with gram-negative bacteria, high prevalence and pathogen resistance, which should be clinically rational use of antimicrobial agents.
