老年呼吸道感染患者病原性细菌的临床检验分析

卢房利

（西安市第四医院，陕西 西安，710004）

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摘要：

目的 分析老年呼吸道感染（RTI）患者病原性细菌的临床检验结果，为治疗老年RTI提供科学的参考依据。方法 从 2015年6月至2016年8月我院收治的老年RTI患者中选取143例作为研究对象，分析其临床资料，观察患者痰细菌培养、 耐药性发生等情况。结果 痰细菌培养情况表明，感染革兰阴性菌共有85 例，占59.44%（85/143）；感染革兰阳性菌共有40例，占27.97%（40/143）；感染真菌共有18例，占12.59%（18/143）。革兰阳性菌、革兰阴性菌及真菌所占比例比较，差异有统计 学意义（X²=18.4871，P=0.0154）。革兰阴性杆菌对氨苄西林的耐药率最高（>95.00%）；革兰阳性球菌对万古霉素不耐受，青霉素耐药率最高；同种革兰阴性菌对不同的药物耐药性不同（P<0.05）；同种革兰阳性菌对不同的药物耐药性不同（P<0.05）。 结论 老年RTI患者的主要病原性细菌为革兰阴性菌，临床治疗中需要根据药敏结果合理选择抗生素。

关键词：老年RTI；革兰阴性菌；革兰阳性菌；临床检验

中图分类号：R56文献标志码：A文章编号：2096-1413(2017)18-0104-02

Clinical analysis of pathogenic bacteria in elderly patients with respiratory tract infection
LU Fang-li
（Xi``an No.4 Hospital, Xi``an 710004, China）

ABSTRACT: Objective To analyze the clinical results of pathogenic bacteria in patients with respiratory tract infection (RTI) and to provide scientific reference for the treatment of RTI. Methods From June 2015 to August 2016, 143 elderly patients with RTI treated in our hospital were selected as the study objects and the clinical data of the patients were analyzed. The sputum culture, drug resistance were observed in the RTI patients. Results The culture of sputum bacteria showed that there were 85 cases (59.44%) of gram-negative bacteria, 40 cases (27.97%) of gram-positive bacteria (40/143), and 18 cases (12.59% ) of fungi. There were significant difference in the proportion of the gram -positive bacteria, gram -negative bacteria and fungi ( X² =18.4871, P=0.0154). Gram -negative bacilli had the highest drug resistance (>95.00%); gram-positive cocci had no drug resistance with vancomycin, the penicillin drug resistance rate reached the highest; the same gram-negative bacteria had different drug resistance to different drugs (P<0.05); the same gram -positive bacteria had different drug resistance to different drugs (P <0.05). Conclusion The main pathogenic
bacteria in elderly patients with RTI are gram -negative bacteria, clinical treatment should be in accordance with the need for rational selection of antibiotics.
KEYWORDS: elderly respiratory tract infection; Gram-negative bacteria; Gram-positive bacteria; clinical test

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