目的 研究武漢市普仁醫(yī)院老年患者下呼吸道感染病原菌的分布及耐藥性，為臨床合理使用抗菌藥物提供經(jīng)驗依據(jù)。方法 對武漢市普仁醫(yī)院2013年1月-2016年6月老年患者下呼吸道感染病原菌的分布及耐藥性進(jìn)行回顧性分析。結(jié)果 共分離出病原菌1 988株，其中革蘭陰性菌1 728例，占86.9%；革蘭陽性菌260例，占13.1%。肺炎克雷伯菌對常用抗菌藥物的耐藥率低于30%，而對氨芐西林的耐藥率為100.0%；大腸埃希菌對青霉素類、頭孢類、氟喹諾酮類、氨基糖苷類、復(fù)方新諾明的耐藥率達(dá)30.0%~90.0%；陰溝腸桿菌對頭孢西丁、氨芐西林、阿莫西林/克拉維酸、氨芐西林/舒巴坦、頭孢唑啉的耐藥率達(dá)68.0%~98.0%，對亞胺培南和美洛培南的耐藥率均為0.0%。銅綠假單胞菌對常用抗菌藥物的耐藥率均低于20%；鮑曼不動桿菌對大部分抗菌藥物的耐藥率超過50%；嗜麥芽窄食單胞菌對所監(jiān)測抗菌藥物的耐藥率低于15%。金黃色葡萄球菌中未發(fā)現(xiàn)萬古霉素、替考拉寧和利奈唑胺的耐藥菌株，青霉素G的耐藥率達(dá)95.9%。肺炎鏈球菌對青霉素G、利奈唑胺和萬古霉素的耐藥率為100.0%。結(jié)論 武漢市普仁醫(yī)院老年患者下呼吸道感染病原菌譜分布廣，仍以革蘭陰性菌為主，其中多數(shù)耐藥嚴(yán)重，臨床應(yīng)結(jié)合藥敏試驗，合理選用抗菌藥物；同時要重視加強細(xì)菌耐藥性的檢測。

Objective To study the distribution and drug resistance of pathogenic bacteria of elderly patients with lower respiratory infection in Wuhan Puren Hospital, in order to further provide the reference for rational use of antibacterial drugs. Methods The distribution and drug resistance of pathogenic bacteria of elderly patients with lower respiratory infection in Wuhan Puren Hospital from January 2013 to June 2016 were analyzed retrospectively. Results Total 1 988 strains of pathogens were isolated, in which Gram-negative bacteria were 1 728 strains (86.9%), and Gram-positive bacteria (260 strains) accounted for 13.1%. The drug resistance rate of Klebsiella pneumoniae against common antibiotics was below 30%, while the drug resistance rate against ampicillin was 100.0%. The drug resistance rate of Escherichia coli against penicillins, cephalosporins, aminoglycosides, and trimethoprim/sulfamethoxazole were 30.0%-90.0%. The drug resistance rate of Enterobacter cloacae against cefoxitin, ampicillin, amoxicillin/clavulanic acid, ampicillin/sulbactam, and cefazolin were 68.0%-98.0%, while E. cloacae was sensitive to imipenem and meropenem. The drug resistance rate of Pseudomonas aeruginosa against common antibiotics was below 20%, while Acinetobacter baumannii was more than 50%. And the drug resistance rate of Stenotrophomonas maltophilia against all monitoring antibiotics was below 15%. There was no Staphylococcus aureus resistance to vancomycin, teicoplanin, linezolid, and the drug resistance rate against penicillin G was 95.9%. Streptococcus pneumoniae was completely resistance to penicillin G, linezolid, and vancomycin. Conclusion The pathogenic bacteria of elderly patients with lower respiratory infection in Wuhan Puren Hospital is widely distributed, and the main pathogens is still Gram-negative bacteria, and most of them are severely resistant to antibiotics. It is important to choose rational antibiotics according to the drug sensitive test and enhance the detection of drug resistance.