目的 研究非ICU病房老年患者下呼吸道感染病原菌分布及耐药性, 为临床合理使用抗菌药物提供依据。方法 对2012年1月—2014年8月武汉市普仁医院非ICU病房诊断为下呼吸道感染的2 326例老年患者痰标本中检出的病原菌分布及耐药性进行统计分析。结果 共检出849株病原菌, 革兰阴性杆菌占78.7%, 革兰阳性球菌占13.3%, 结核分枝杆菌占4.6%, 真菌占3.3%。革兰阴性杆菌对亚胺培南、美洛培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦较敏感。金黄色葡萄球菌对复方新诺明、氯霉素、四环素较敏感, 肺炎链球菌对青霉素、氯霉素、左氧氟沙星、莫西沙星较敏感, 未发现耐万古霉素、替考拉宁和利奈唑胺革兰阳性球菌。结论 非ICU病房老年下呼吸道感染病原菌谱分布广泛, 仍以革兰阴性杆菌为主, 细菌耐药性有较大差异, 临床医师应根据病原学监测资料有针对性地选择抗菌药。

Objective To study the distribution and drug resistance of non-ICU elderly patients with lower respiratory infection, further providing the basis for the clinical rational use of drug. Methods Distribution and drug resistance of 2 326 strains from the sputum specimen of elderly patients with lower respiratory tract infection in Wuhan Puren Hospital from January 2012 to August 2014 were analyzed, retrospectively. Results Totally 849 strains of bacteria were isolated, including Gram-negative bacilli, Gram-positive cocci, Mycobacteria tuberculosis and Fungus, which shared the fractions of 78.7%, 13.3%, 4.6%, and 3.3%, respectively. Strains of Enterobacteriaceae were highly sensitive to imipenem, meropenem, piperacillin/tazobactam, and cefoperazone/sulbactam. Staphylococcus aureus was highly sensitive to trimethoprim/sulfamethoxazole, chloramphenicol, and tetracycline. Streptococcus pneumoniae was highly sensitive to penicillin, chloramphenicol, levofloxacin, and moxifloxacin. However, Gram-positive cocci resistant to vancomycin, teicoplanin and linezolid was not found. Conclusion Though pathogenic bacteria causing lower respiratory tract infection in Non-ICU senile patients are widely distributed, the main pathogen is still Gram-negative bacilli. There are big differences between bacterial drug resistance. Doctors should recommend a targeted selection of antibiotics based on the etiology of monitoring data.