摘要
目的分析医院老年肺部感染患者痰培养结果及耐药情况,以指导临床医生合理应用抗生素经验用药。方法收集2018年1月至2022年12月山东电力中心医院住院老年患者(>60岁)痰培养数据,分析不同年龄段患者各菌株感染率及耐药率变化,并用SPSS 20.0软件对其进行数据分析。结果2583例老年患者痰标本分离培养出阳性菌株1386株(53.66%),不同年龄组分离最多的均为铜绿假单胞菌。去除缺乏药敏结果的部分数据后,对505株阳性菌株进行统计,共分离出50株(9.90%)革兰阳性菌,以金黄色葡萄球菌36株(7.13%)占比最高;455株(90.10%)革兰阴性菌,铜绿假单胞菌163株(32.28%)占比最高。耐药性分析可见,革兰阴性菌中铜绿假单胞菌对左氧氟沙星的耐药性最高(37.42%);肺炎克雷伯菌对氨苄西林耐药性最高(86.59%),其次为复方磺胺甲唑(58.54%);鲍曼不动杆菌对头孢他啶、氨苄西林、复方磺胺甲唑、环丙沙星的耐药性均高于50.00%。革兰阳性菌中金黄色葡萄球菌对青霉素、克拉霉素、红霉素、阿奇霉素耐药率均大于60%;溶血性葡萄球菌对左氧氟沙星、青霉素、红霉素、苯唑西林、阿奇霉素耐药率均为100%。结论老年患者痰培养标本中,革兰阴性杆菌为肺部感染主要致病菌,以铜绿假单胞菌、肺炎克雷伯菌和鲍曼不动杆菌为主,且对所监测的抗生素呈不同程度耐药,应定期分析总结,为抗菌药物的合理使用提供指导。
Objective To analyze the sputum culture results and drug resistance of elderly patients with pulmonary infection in the hospital,providing reference for clinical doctors to carry out rational antimicrobial drug experience.Methods Collected sputum culture data from hospitalized elderly patients(>60 years old)in Shandong Electric Power Center Hospital from January 2018 to December 2022,analyzed the changes of the infection rates and drug resistance rates of various strains in patients of different age groups,and used SPSS 20.0 software to analyze the data.Results Sputum specimens from 2583 elderly patients were isolated and cultured with 1386 positive strains(53.66%).The most isolated strains in each age group were Pseudomonas aeruginosa.After removing data lacking drug sensitivity results,505 positive strains were counted,50 strains(9.90%)Gram positive strains were isolated,including 36 strains(7.13%)of Staphylococcus aureus;455 strains(90.10%)of Gram negative bacteria were isolated,with 163 strains(32.28%)of Pseudomonas aeruginosa accounting for the highest proportion from the analysis of drug resistance,it can be seen that Gram negative bacteria:Pseudomonas aeruginosa had the highest resistance to levofloxacin(37.42%),Klebsiella pneumoniae has the highest resistance to ampicillin(86.59%)followed by compound sulfamethoxazole(58.54%).The resistance rates of Acinetobacter baumannii to ceftazidime,ampicillin,compound sulfamethoxazole,and ciprofloxacin were all higher than 50.00%.Gram positive bacteria:Staphylococcus aureus has a resistance rate of over 60%to penicillin,clarithromycin,erythromycin and azithromycin.The resistance rates of hemolytic staphylococcus to levofloxacin,penicillin,erythromycin,oxacillin and azithromycin were all 100%.Conclusion In sputum culture samples of elderly patients,Gram negative bacteria were the main pathogenic bacteria for pulmonary infection,mainly Pseudomonas aeruginosa,Klebsiella pneumoniae,and Acinetobacter baumanni.They all have various degrees of resistance to different antibiotics,which should be analyzed and summarized on a regular basis,to provide guidance for the rational use of antimicrobial drugs.
作者
田伟田
Tian Weitian(Department of Laboratory Medicine,Shandong Electric Power Center Hospital,Jinan,Shandong 250001,China)
出处
《实用医技杂志》
2023年第12期863-866,共4页
Journal of Practical Medical Techniques
关键词
痰培养
抗菌药
抗药性
细菌
老年人
Sputum culture
Anti-bacterial agents
Drug resistance,bacterial
Aged
