目的 研究武汉市普仁医院老年患者下呼吸道感染病原菌的分布及耐药性，为临床合理使用抗菌药物提供经验依据。方法 对武汉市普仁医院2013年1月-2016年6月老年患者下呼吸道感染病原菌的分布及耐药性进行回顾性分析。结果 共分离出病原菌1 988株，其中革兰阴性菌1 728例，占86.9%；革兰阳性菌260例，占13.1%。肺炎克雷伯菌对常用抗菌药物的耐药率低于30%，而对氨苄西林的耐药率为100.0%；大肠埃希菌对青霉素类、头孢类、氟喹诺酮类、氨基糖苷类、复方新诺明的耐药率达30.0%~90.0%；阴沟肠杆菌对头孢西丁、氨苄西林、阿莫西林/克拉维酸、氨苄西林/舒巴坦、头孢唑啉的耐药率达68.0%~98.0%，对亚胺培南和美洛培南的耐药率均为0.0%。铜绿假单胞菌对常用抗菌药物的耐药率均低于20%；鲍曼不动杆菌对大部分抗菌药物的耐药率超过50%；嗜麦芽窄食单胞菌对所监测抗菌药物的耐药率低于15%。金黄色葡萄球菌中未发现万古霉素、替考拉宁和利奈唑胺的耐药菌株，青霉素G的耐药率达95.9%。肺炎链球菌对青霉素G、利奈唑胺和万古霉素的耐药率为100.0%。结论 武汉市普仁医院老年患者下呼吸道感染病原菌谱分布广，仍以革兰阴性菌为主，其中多数耐药严重，临床应结合药敏试验，合理选用抗菌药物；同时要重视加强细菌耐药性的检测。

Objective To study the distribution and drug resistance of pathogenic bacteria of elderly patients with lower respiratory infection in Wuhan Puren Hospital, in order to further provide the reference for rational use of antibacterial drugs. Methods The distribution and drug resistance of pathogenic bacteria of elderly patients with lower respiratory infection in Wuhan Puren Hospital from January 2013 to June 2016 were analyzed retrospectively. Results Total 1 988 strains of pathogens were isolated, in which Gram-negative bacteria were 1 728 strains (86.9%), and Gram-positive bacteria (260 strains) accounted for 13.1%. The drug resistance rate of Klebsiella pneumoniae against common antibiotics was below 30%, while the drug resistance rate against ampicillin was 100.0%. The drug resistance rate of Escherichia coli against penicillins, cephalosporins, aminoglycosides, and trimethoprim/sulfamethoxazole were 30.0%-90.0%. The drug resistance rate of Enterobacter cloacae against cefoxitin, ampicillin, amoxicillin/clavulanic acid, ampicillin/sulbactam, and cefazolin were 68.0%-98.0%, while E. cloacae was sensitive to imipenem and meropenem. The drug resistance rate of Pseudomonas aeruginosa against common antibiotics was below 20%, while Acinetobacter baumannii was more than 50%. And the drug resistance rate of Stenotrophomonas maltophilia against all monitoring antibiotics was below 15%. There was no Staphylococcus aureus resistance to vancomycin, teicoplanin, linezolid, and the drug resistance rate against penicillin G was 95.9%. Streptococcus pneumoniae was completely resistance to penicillin G, linezolid, and vancomycin. Conclusion The pathogenic bacteria of elderly patients with lower respiratory infection in Wuhan Puren Hospital is widely distributed, and the main pathogens is still Gram-negative bacteria, and most of them are severely resistant to antibiotics. It is important to choose rational antibiotics according to the drug sensitive test and enhance the detection of drug resistance.