目的 研究非ICU病房老年患者下呼吸道感染病原菌分布及耐藥性, 為臨床合理使用抗菌藥物提供依據(jù)。方法 對(duì)2012年1月—2014年8月武漢市普仁醫(yī)院非ICU病房診斷為下呼吸道感染的2 326例老年患者痰標(biāo)本中檢出的病原菌分布及耐藥性進(jìn)行統(tǒng)計(jì)分析。結(jié)果 共檢出849株病原菌, 革蘭陰性桿菌占78.7%, 革蘭陽性球菌占13.3%, 結(jié)核分枝桿菌占4.6%, 真菌占3.3%。革蘭陰性桿菌對(duì)亞胺培南、美洛培南、哌拉西林/他唑巴坦、頭孢哌酮/舒巴坦較敏感。金黃色葡萄球菌對(duì)復(fù)方新諾明、氯霉素、四環(huán)素較敏感, 肺炎鏈球菌對(duì)青霉素、氯霉素、左氧氟沙星、莫西沙星較敏感, 未發(fā)現(xiàn)耐萬古霉素、替考拉寧和利奈唑胺革蘭陽性球菌。結(jié)論 非ICU病房老年下呼吸道感染病原菌譜分布廣泛, 仍以革蘭陰性桿菌為主, 細(xì)菌耐藥性有較大差異, 臨床醫(yī)師應(yīng)根據(jù)病原學(xué)監(jiān)測(cè)資料有針對(duì)性地選擇抗菌藥。

Objective To study the distribution and drug resistance of non-ICU elderly patients with lower respiratory infection, further providing the basis for the clinical rational use of drug. Methods Distribution and drug resistance of 2 326 strains from the sputum specimen of elderly patients with lower respiratory tract infection in Wuhan Puren Hospital from January 2012 to August 2014 were analyzed, retrospectively. Results Totally 849 strains of bacteria were isolated, including Gram-negative bacilli, Gram-positive cocci, Mycobacteria tuberculosis and Fungus, which shared the fractions of 78.7%, 13.3%, 4.6%, and 3.3%, respectively. Strains of Enterobacteriaceae were highly sensitive to imipenem, meropenem, piperacillin/tazobactam, and cefoperazone/sulbactam. Staphylococcus aureus was highly sensitive to trimethoprim/sulfamethoxazole, chloramphenicol, and tetracycline. Streptococcus pneumoniae was highly sensitive to penicillin, chloramphenicol, levofloxacin, and moxifloxacin. However, Gram-positive cocci resistant to vancomycin, teicoplanin and linezolid was not found. Conclusion Though pathogenic bacteria causing lower respiratory tract infection in Non-ICU senile patients are widely distributed, the main pathogen is still Gram-negative bacilli. There are big differences between bacterial drug resistance. Doctors should recommend a targeted selection of antibiotics based on the etiology of monitoring data.