肾内科老年患者肺部感染病原菌分布与耐药性分析

金刚，冯婷，董倩兰，李振江，闫晓辉

（陕西省人民医院肾内科，陕西 西安，710065）

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摘要：

目的 分析肾内科老年肺部感染患者的病原菌分布及耐药性，降低患者肺部感染率，以提高临床治疗效果。方法 回顾性分析我院肾内科收治的50例老年肺部感染患者的临床资料，分析患者感染的病原菌分布与耐药性，并给出具体的应对措施。结果 50例患者总共分出65株病原菌，其中革兰阴性菌36株为55.4%，其中主要为大肠埃希菌与铜绿假单胞菌，革兰阳 性菌26株占44.6%，主要为金黄色葡萄球菌与粪肠肠球为主。金黄色葡萄球菌对阿奇霉素、红霉素、克林霉素、苯唑西林、青霉素耐药率大于70.0%，粪肠球菌对克林霉素、阿奇霉素、红霉素、磺胺甲恶唑/甲氧苄啶耐药率大于85.0%。大肠埃希菌对头 孢他啶、氨曲南、庆大霉素及哌拉西林/他唑巴坦耐药性大于80.0%；铜绿假单胞菌对头孢他啶、氨曲南、哌拉西林/他唑巴坦耐药率大于或等于80.0%。结论 肾内科老年住院患者感染的病原菌分布较为集中，需要做好病房环境致病菌的清洁消毒工 作，以有效降低医院感染的发生率。

关键词：肾内科；肺部感染；病原学

中图分类号：R197.323文献标志码：A文章编号：2096-1413(2017)16-0056-02

Analysis of pathogenic bacteria distribution and drug resistance in nephrology elderly patients with pulmonary infection
JIN Gang, FENG Ting, DONG Qian-lan, LI Zhen-jiang, YAN Xiao-hui


(Department of Nephrology, Shaanxi Provincial Hospital, Xi`an 710065, China)

ABSTRACT: Objective To investigate the pathogenic bacteria distribution and drug resistance in nephrology elderly patients with pulmonary infection and reduce pulmonary infection rate, so as to improve the clinical effect. Methods The clinical data of 50 elderly patients with pulmonary infections who treated in nephrology of our hospital were retrospectively analyzed. The pathogenic bacteria distribution and drug resistance of the patients were analyzed, and the specific countermeasures were put forward. Results A total of 66 strains of pathogens have been isolated from the 50 elderly patients, including 36 (55.4%) strains of gram negative bacteria and 26 (44.6%) strains of gram positive bacteria. The escherichia coli and pseudomonas aeruginosa were the predominant species of gram negative bacteria; the staphylococcus aureus and enterococcus faecalis were dominant among the gram positive bacteria. The drug resistance rates of azithromycin, erythromycin, clindamycin, oxacillin and penicillin were more than 70.0％ on staphylococcus aureus; the drug resistance rates of clindamycin, azithromycin, erythromycin and sulfamethoxazole trimethoprim were more than 85.0％ on enterococcus faecalis. The drug resistance rates of ceftazidime, aztreonam, gentamicin and piperacillin tazobactam were more than 80.0% on escherichia coli; the drug resistance rates of ceftazidime, aztreonam and piperacillin tazobactam were more than 80.0% on pseudomonas aeruginosa. Conclusion The pathogenic bacteria causing infections in the nephrology elderly patients show relatively concentrated distribution. It is necessary to strengthen the cleaning and disinfection of the major pathogens in the ward environment, so as to reduce the incidence of nosocomial infections.
KEYWORDS: nephrology; pulmonary infection; etiological analysis

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