老年气管插管患者下呼吸道感染细菌分布及 耐药性分析

目的研究老年气管插管患者下呼吸道感染的病原菌分布及耐药情况,为临床插管前预防性经验用药提供参考。方法回顾性分析2014-2016年上海市虹口区江湾医院老年气管插管患者的病原菌分布及耐药性情况。结果 560例标本中共检出177株致病菌,其中革兰阴性杆菌121株(68.36%),以肺炎克雷伯菌、铜绿假单胞菌为主;除鲍曼不动杆菌/溶血不动杆菌外,其他革兰阴性杆菌对亚胺培南、美罗培南敏感性均较高。革兰阳性球菌检出52株(29.38%),以金黄色葡萄球菌为主(其中MRSA 37株),对万古霉素敏感性较高。另外分离到真菌4株。结论气管插管患者下呼吸道感染致病菌以肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌为主。在临床应用中,应根据本地区、本医院的病原菌分布状况和细菌耐药情况,给予适当药物,预防感染。

The distribution and drug resistance of pathogens in elderly lower respiratory tract infection patients with endotracheal intubation

Abstract: Objective To explore the distribution and drug resistance of pathogens in elderly lower respiratory tract infection patients with tracheal intubation, and provide reference for preventive use of drugs before clinical intubation. Methods The distribution and drug resistance of pathogens isolated from elderly tracheal intubation patients in Jiangwan hospital from 2014 to 2016 were analyzed retrospectively. Results A total of 177 strains of pathogenic bacteria were detected in 560 specimens, among which 121 strains were Gram-negative bacilli (68.36%), with Klebsiella pneumoniae and Pseudomonas aeruginosa being predominant pathogens. Except Bauman baumannii/Acinetobacter baumannii, these Gram-negative bacilli were highly sensitive to Imipenem and Meropenem. 52 strains of Gram-positive cocci were detected, among which Staphylococcus aureus was the main pathogen (including 37 strains of MRSA) with high sensitivity to Vancomycin. 4 strains of fungi were isolated. Conclusion The main pathogens causing lower respiratory tract infection in patients with tracheal intubation were Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus. We should take into account the distribution and the drug resistance of pathogens to use appropriate drugs for prevention of infection.