CAJ | 학술논문

目的：探讨老年重叠综合征合并肺部感染的病原菌构成及耐药性特点，为临床合理使用抗生素提供依据。方法对107例老年重叠综合征合并肺部感染患者的痰标本进行细菌培养，分析病原菌的构成及药物敏感性。结果共分离出致病菌71株，其中革兰氏阴性菌44株(62.0%)，分别为铜绿假单胞菌16株(22.5%)，大肠埃希菌9株(12.7%)，肺炎克雷伯菌8株(11.3%)，鲍曼不动杆菌7株(9.9%)，阴沟肠杆菌4株(5.6%)。革兰氏阳性菌10株(14.1%)，分别为金黄色葡萄球菌6株(8.5%)，溶血葡萄球菌4株(5.6%)。真菌17株(24.0%)，包括白色假丝酵母菌11株(15.5%)，光滑假丝酵母菌4株(5.6%)，热带假丝酵母菌2株(2.8%)。革兰氏阴性菌对哌拉西林他唑巴坦、头孢哌酮舒巴坦及碳青霉烯类抗生素耐药率较低，革兰氏阳性菌未发现对替加环素、万古霉素、利奈唑胺耐药菌株，真菌对两性霉素B、氟康唑、伏立康唑、伊曲康唑均敏感。结论老年重叠综合征合并肺部感染病原菌以革兰氏阴性菌为主，耐药率较高，可经验性选用含β内酰胺酶抑制剂的复合抗生素或碳青霉烯类抗生素。
목적：탐토노년중첩종합정합병폐부감염적병원균구성급내약성특점，위림상합리사용항생소제공의거。방법대107례노년중첩종합정합병폐부감염환자적담표본진행세균배양，분석병원균적구성급약물민감성。결과공분리출치병균71주，기중혁란씨음성균44주(62.0%)，분별위동록가단포균16주(22.5%)，대장애희균9주(12.7%)，폐염극뢰백균8주(11.3%)，포만불동간균7주(9.9%)，음구장간균4주(5.6%)。혁란씨양성균10주(14.1%)，분별위금황색포도구균6주(8.5%)，용혈포도구균4주(5.6%)。진균17주(24.0%)，포괄백색가사효모균11주(15.5%)，광활가사효모균4주(5.6%)，열대가사효모균2주(2.8%)。혁란씨음성균대고랍서림타서파탄、두포고동서파탄급탄청매희류항생소내약솔교저，혁란씨양성균미발현대체가배소、만고매소、리내서알내약균주，진균대량성매소B、불강서、복립강서、이곡강서균민감。결론노년중첩종합정합병폐부감염병원균이혁란씨음성균위주，내약솔교고，가경험성선용함β내선알매억제제적복합항생소혹탄청매희류항생소。
Objective To explore the distribution of pathogen and the characteristics of drug resistance in se-nile overlap syndrome (OS) accompanied by pulmonary infection, so as to provide basis for rational usage of antibiot-ics. Methods The sputum samples of 107 senile OS patients accompanied by pulmonary infection were collected for bacteria culture. The pathogenic distribution and drug sensitivity were analyzed. Results A total of 71 pathogens were isolated. Among the 71 pathogens, 44 strains were Gram-negative bacteria (62.0%), including Pseudomonas (16 strains, 22.5%), Escherichia coli (9 strains, 12.7%), Klebsiella (8 strains, 11.3%), Baumanii (7 strains, 9.9%), Entero-bacter cloacae (4 strains, 5.6%). Ten strains were Gram-positive bacteria (14.1%), including Staphylococcus aureus (6 strains, 8.5%), Staphylococcus haemolyticus (4 strains, 5.6%). Seventeen strains were fungi (24.0%), including Candida albicans (11 strains, 15.5%), Candida glabrata (4 strains, 5.6%), Candida tropicalis (2 strains, 2.8%). Gram-negative bacteria showed lower drug resistance to piperacillin tazobactam, cefoperazone shubatan and carbapenems. No strain showed resistance to tigecycline, vancomycin and linezolid in Gram-positive bacteria. The fungi detected were all sen-sitive to amphotericin B, fluconazole, voriconazole and itraconazole. Conclusion The senile OS patients accompa-nied by pulmonary infection are mostly affected with Gram-negative bacteria, which have high levels of resistance to antibiotics. According to experience, it is appropriate to choose the compound antibiotics containing beta lactamase in-hibitor or carbapenems.