老年重叠综合征合并肺部感染的病原菌构成及药敏分析张超，顾珏，芮.doc

老年重叠综合征合并肺部感染的病原菌构成及药敏分析 张 超，顾 珏，芮 萌，宋秀杰，方庭正，韩文杰，欧 敏 (海军总医院干部呼吸科，北京 100048) 　　 【摘要】 目的 探讨老年重叠综合征合并肺部感染的病原菌构成及耐药性特点，为临床合理使用抗生素提供依据。方法 对107例老年重叠综合征合并肺部感染患者的痰标本进行细菌培养，分析病原菌的构成及药物敏感性。结果 共分离出致病菌71株，其中革兰氏阴性菌44株(62.0%)，分别为铜绿假单胞菌16株(22.5%)，大肠埃希菌9株(12.7%)，肺炎克雷伯菌8株(11.3%)，鲍曼不动杆菌7株(9.9%)，阴沟肠杆菌4株(5.6%)。革兰氏阳性菌10株(14.1%)，分别为金黄色葡萄球菌6株(8.5%)，溶血葡萄球菌4株(5.6%)。真菌17株(24.0%)，包括白色假丝酵母菌11株(15.5%)，光滑假丝酵母菌4株(5.6%)，热带假丝酵母菌2株(2.8%)。革兰氏阴性菌对哌拉西林他唑巴坦、头孢哌酮舒巴坦及碳青霉烯类抗生素耐药率较低，革兰氏阳性菌未发现对替加环素、万古霉素、利奈唑胺耐药菌株，真菌对两性霉素B、氟康唑、伏立康唑、伊曲康唑均敏感。结论 老年重叠综合征合并肺部感染病原菌以革兰氏阴性菌为主，耐药率较高，可经验性选用含β内酰胺酶抑制剂的复合抗生素或碳青霉烯类抗生素。　　 【关键词】 重叠综合征;肺部感染;病原菌;药敏分析　　 【中图分类号】 R442.8 【文献标识码】 B 【文章编号】 1003—6350 (2015) 17—2622—03 　　 Distribution of pathogen and drug susceptibility analysis in senile overlapsyndrome accompanied by pulmonary infection. ZHANG Chao, GU Jue, RUI Meng, SONG Xiu-jie, FANG Ting-zheng, HAN Wen-jie, OU Min. Department of Cadre Respiration Medicine, Navy General Hospital of Chinese PLA, Beijing 100048, CHINA 　　 【Abstract】 Objective To explore the distribution of pathogen and the characteristics of drug resistance in senile overlap syndrome (OS) accompanied by pulmonary infection, so as to provide basis for rational usage of antibiotics. Methods The sputum samples of 107 senile OS patients accompanied by pulmonary infection were collected for bacteria culture. The pathogenic distribution and drug sensitivity were analyzed. Results A total of 71 pathogens were isolated. Among the 71 pathogens, 44 strains were Gram-negative bacteria (62.0%), including Pseudomonas (16 strains, 22.5%), Escherichia coli (9 strains, 12.7%), Klebsiella (8 strains, 11.3%), Baumanii (7 strains, 9.9%), Enterobacter cloacae (4 strains, 5.6%). Ten strains were Gram-positive bacteria (14.1%), including Staphylococcus aureus (6 strains, 8.5%), Staphylococcus haemolyticus (4 strains, 5.6%). Seventeen strains were fungi (24.0%), including Candida albicans (11 strains, 15.5%), Candida glabrata (4 strains, 5.6%), Candida tropicalis (2 strains, 2.8%). Gram-neg