老年病区常见病原菌构成及其耐药性变迁
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徐鸣皋

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R181.3+2

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Distribution and change of antimicrobial resistance of common pathogenic bacteria from geriatric ward
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    摘要:

    目的分析老年病区分离的常见病原菌构成及其耐药性变迁,为临床合理使用抗菌药物提供参考。方法分析2009—2013年某院老年病区住院患者送检标本,对检出病原菌及耐药情况进行统计分析。结果2009—2013年共检出病原菌7 426株,其中革兰阴性(G-)杆菌6 755株(占90.96%),革兰阳性(G+)球菌537株(占7.23%),真菌134株(占1.81%)。检出菌株数居前5位的依次为铜绿假单胞菌(39.16%)、大肠埃希菌(16.47%)、嗜麦芽窄食单胞菌(10.65%)、肺炎克雷伯菌(7.22%)及鲍曼不动杆菌(6.21%),居前5位的细菌标本来源主要为痰(5 573株,占94.15%)。鲍曼不动杆菌对检测的所有抗菌药物耐药率均呈上升趋势(均P<0.01);铜绿假单胞菌对哌拉西林/他唑巴坦、头孢他啶、氨曲南、亚胺培南等8种常见抗菌药物,以及大肠埃希菌对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、氨曲南、左氧氟沙星及环丙沙星5种常见抗菌药物的耐药率均呈上升趋势(均P<0.01);肺炎克雷伯菌对检测的所有抗菌药物耐药率均无明显变化(均P>0.05)。嗜麦芽窄食单胞菌对头孢他啶和左氧氟沙星的耐药率呈上升趋势(均P<0.01)。结论老年病区分离的病原菌以铜绿假单胞菌为主,其对多种常见抗菌药物耐药率高,且日趋严重,临床应根据药敏试验结果合理选用抗菌药物。

    Abstract:

    ObjectiveTo analyze the distribution and change of antimicrobial resistance of common pathogenic bacteria from geriatric ward, and provide  reference for rational use of antimicrobial agents.MethodsSpecimens from hospitalized patients in a geriatric ward from 2009 to 2013 were analyzed, the isolated pathogenic bacteria and antimicrobial resistance of bacteria were analyzed statistically.ResultsFrom 2009 to 2013, a total of 7 426 pathogenic bacteria were isolated, the percentage of gramnegative bacilli, grampositive cocci, and fungi were  90.96%(n=6 755),7.23%(n=537),and 1.81%(n=134),respectively. The top 5 detected bacteria  were  Pseudomonas aeruginosa (39.16%), Escherichia coli (16.47%), Stenotrophomonas maltophilia (10.65%), Klebsiella pneumoniae (7.22%), and Acinetobacter baumannii (6.21%), these strains were mainly isolated from sputum(94.15%,n=5 573). Resistance rates of Acinetobacter baumannii to all detected antimicrobial agents, Pseudomonas aeruginosa to 8 kinds of common antimicrobial agents (piperacillin / tazobactam, ceftazidime, aztreonam, imipenem, et al), Escherichia coli to 5 kinds of common antimicrobial agents (piperacillin / tazobactam, cefoperazone/sulbactam, aztreonam, levofloxacin, and ciprofloxacin), and Stenotrophomonas maltophilia to ceftazidime and levofloxacin all showed an increased tendency (all P<0.01); there was no obvious change in resistance rates of Klebsiella pneumoniae to all detected antimicrobial agents (all P>0.05).ConclusionThe major pathogenic bacteria isolated from geriatric ward is Pseudomonas aeruginosa, which is highly resistant to multiple antimicrobial agents, antimicrobial agents should be chosen based on antimicrobial susceptibility testing results.

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徐鸣皋, 丁进亚, 徐娟,等.老年病区常见病原菌构成及其耐药性变迁[J]. 中国感染控制杂志,2016,15(1):26-30. DOI:10.3969/j. issn.1671-9638.2016.01.006.
XU Minggao, DING Jinya, XU Juan, et al. Distribution and change of antimicrobial resistance of common pathogenic bacteria from geriatric ward[J]. Chin J Infect Control, 2016,15(1):26-30. DOI:10.3969/j. issn.1671-9638.2016.01.006.

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  • 收稿日期:2015-03-22
  • 最后修改日期:2015-05-22
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  • 在线发布日期: 2016-01-31
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