老年与中青年患者下呼吸道感染病原菌的对比分析

目的对比分析老年与中青年患者下呼吸道感染病原菌的分布规律及其耐药性特点,以指导临床合理用药。方法将研究对象分为老年(≥60岁)和中青年(20～59岁)2组;采用API系统进行菌种鉴定;采用K-B法进行药敏试验;采用纸片扩散表型确证法进行超广谱β-内酰胺酶(ESBLs)测定;采用SPSS 13.0进行χ2检验。结果老年组的真菌分离率显著高于中青年组,以白色假丝酵母菌最多;中青年组的G-杆菌分离率显著高于老年组,以铜绿假单胞菌最多;老年组主要致病菌对多数药物的耐药率比中青年组有增高趋势,但差异多无统计学意义;老年组肺炎克雷伯菌的ESBLs阳性率显著高于中青年组。结论老年与中青年患者下呼吸道感染的病原菌分布及耐药性存在一定差异。

Comparative analysis of pathogens in lower respiratory tract infections between elderly patients and young patients

Objective To investigate the distribution and drug resistance of pathogenic bacteria from lower respiratory tract infection in elderly and young patients, so as to provide basis for reasonable application of antibiotics. Method uSubjects were divided into elder （ ≥60 years） and young （20 to 59 years） groups. Clinical isolates were identified by API system and their drug resistance was tested by K-B method. The ESBLs-producing strains were detected by diffusion confirmed method. Statistical analysis was performed by SPSS 13.0 software. Result The percentage of fungi from elderly patients was significantly higher than that from young patients, with Candida albicans being predominant. The percentage of Gram-negative bacteria from young patients was significantly higher than that from elderly patients, with Pseudomonas aeruginosa being predominant. The drug resistance rates of major pathogens from elderly patients had an increasing tendency compared with that of young ones, but most of the differences was not statistically significant. ESBLs in Klebsiella pneumoniae from elderly patients were significantly higher than those from young patients. Conclusion The distribution and drug resistance of pathogenic bacteria from lower respiratory tract infection have some differences in between elderly and young patients.