老年支气管扩张合并急性感染的病原菌及其耐药性研究

目的: 了解老年支气管扩张患者急性感染的病原学分布及药敏情况, 指导临床抗菌药物的使用。方法: 对2000—2012 年本院呼吸科104份老年支气管扩张急性感染患者的痰标本进行细菌培养及药敏试验。结果: 150 例痰标本分离出致病菌107 株, 其中革兰氏阴性菌 87 株, 占81%, 排在前 3 位的致病菌分别是铜绿假单胞菌( 35%),肺炎克雷伯菌( 14% ),鲍曼不动杆菌(11%)。革兰氏阳性球菌8株(7%),真菌12株(11%)。药敏实验显示所分离出的革兰氏阴性杆菌对哌拉西林-他唑巴坦, 第 3、4 代头孢菌素及碳青霉烯类、多粘菌素等抗菌药物敏感性较高。结论: 老年支气管扩张急性感染的病原菌分布以革兰氏阴性杆菌为主, 铜绿假单胞菌排在首位,经验治疗时建议选用哌拉西林/他唑巴坦、头孢三代、四代或碳青霉烯类药物。

Pathogens and drug resistant rate analysis of aged of bronchiectasis patients in an acute exacerbation

AIM: To learn the situation of pathogens distribution and drug sensitivity in aged bronchiectasis in an acute exacerbation.METHODS: 150 samples of sputum bacteria culture and drug sensitivity tests from 104 aged patients were performed in our hospital from 2000 to 2012.RESULTS: 107 isolates isolated from 150 sputum samples, among them there were 87 isolates of gram-negative bacillus (81%). The most common Gram-negative bacillus isolated were Pseudomonas aeruginosa(35%), Klebsiella pneumoniae(14% ), Acinetobacter baumannii(11%). There were 8 strains of gram-positive bacteria(7%),12 strains of fungi(11%). Piperacillin/tabazotani, three generation cephalosporin,four generation cephalosporin carbapenem,and quinolone has better antimicrobial activity against. gram-negative bacillus.CONCLUSION: The main pathogen of aged bronchiectasis in an acute exacerbation was gram negative bacteria, pseudomonas aeruginosa was the most commen pathogens among them. Piperacillin/tabazotani, three generation cephalosporin, four generation cephalosporin, carbapenem should be recommended to treat these aged bronchiectasis patients.