本文關(guān)鍵詞：老年重癥肺炎患者病原菌構(gòu)成及其死亡危險(xiǎn)因素　出處：《中國(guó)老年學(xué)雜志》2017年08期 　論文類型：期刊論文

  更多相關(guān)文章： 重癥肺炎 病原學(xué)檢測(cè)

【摘要】：目的探討老年重癥肺炎患者病原菌構(gòu)成及其死亡危險(xiǎn)因素。方法選取老年重癥肺炎住院患者136例,詳細(xì)記錄患者性別、年齡、合并基礎(chǔ)疾病種類、實(shí)驗(yàn)室檢查結(jié)果,全面評(píng)估患者肺部感染情況,對(duì)患者進(jìn)行痰液檢查,行相關(guān)病原學(xué)檢查。結(jié)果 136例患者痰液標(biāo)本中共檢出病原菌114株。其中革蘭陰性菌75株,以鮑曼不動(dòng)桿菌、銅綠假單胞菌最常見(jiàn);革蘭陽(yáng)性菌26株,以耐甲氧西林金黃色葡萄球菌、溶血性葡萄球菌、肺炎鏈球菌較為常見(jiàn);真菌13株,以白色假絲酵母菌為主。革蘭陰性菌中鮑曼不動(dòng)桿菌對(duì)氨芐西林不敏感,耐藥率100.00%,對(duì)亞胺培南西司他汀鈉、阿米卡星較敏感,耐藥率分別為3.85%和15.38%;銅綠假單胞菌對(duì)阿米卡星敏感,耐藥率為16.67%,對(duì)氨芐西林耐藥率較高,為77.78%。革蘭陽(yáng)性菌中耐甲氧西林葡萄球菌對(duì)利奈唑胺鈉敏感性較高,耐藥率為23.07%,對(duì)氨芐西林、亞胺培南西司他汀鈉不敏感,耐藥率高達(dá)100.00%;溶血性葡萄球菌對(duì)亞胺培南西司他汀鈉和利奈唑胺、頭孢吡肟較為敏感,耐藥率為14.29%和28.57%,28.57%,而對(duì)頭孢呋辛和氨芐西林不敏感,耐藥率均為71.43%和85.71%。累及器官超過(guò)3個(gè)、合并慢性阻塞性肺疾病(COPD)是老年重癥肺炎患者死亡的獨(dú)立危險(xiǎn)因素。結(jié)論老年重癥肺炎患者主要致病菌為革蘭陰性菌,主要革蘭陰性菌對(duì)阿米卡星,亞胺培南西司他汀鈉敏感,主要革蘭陽(yáng)性菌對(duì)利奈唑胺敏感,而患者的愈后與累及器官超過(guò)3個(gè)、合并COPD呈正相關(guān)。
[Abstract]:Objective to investigate the pathogenic bacteria composition and death risk factors in elderly patients with severe pneumonia. Methods 136 elderly patients with severe pneumonia were selected to record their sex, age and basic diseases in detail. The results of laboratory examination were used to evaluate the pulmonary infection and sputum examination. Results 114 strains of pathogenic bacteria were detected in sputum of 136 patients, 75 of them were Gram-negative bacteria, Acinetobacter baumannii and Pseudomonas aeruginosa were the most common. Gram-positive bacteria 26 strains, methicillin-resistant Staphylococcus aureus, haemolytic Staphylococcus, Streptococcus pneumoniae more common; Acinetobacter baumannii was not sensitive to ampicillin in Gram-negative bacteria, and the drug resistance rate was 100.00m, and was sensitive to imipenem and amikacin. The drug resistance rates were 3.85% and 15.38, respectively. Pseudomonas aeruginosa was sensitive to amikacin with a resistance rate of 16.67 and a higher resistance to ampicillin. The sensitivity of methicillin-resistant Staphylococcus to linazolamine sodium was higher, the resistance rate was 23.07, and was not sensitive to ampicillin and imipenem sodium. The drug resistance rate was as high as 100.00g. Staphylococcus haemolyticus was sensitive to imipenem statin sodium and linazolamine and cefepime with resistance rates of 14.29% and 28.57% respectively. Cefuroxime and ampicillin were insensitive to cefuroxime and ampicillin. The drug resistance rates were 71.43% and 85.71, respectively. More than 3 organs were involved. Conclusion the main pathogenic bacteria in elderly patients with severe pneumonia are gram-negative bacteria and the main gram-negative bacteria to amikacin. Imipenem cilastatin sodium was sensitive and the main gram-positive bacteria were sensitive to linazolamine, and the recovery of the patients was positively correlated with the involvement of more than 3 organs and COPD.
【作者單位】： 武漢市紅十字會(huì)醫(yī)院武漢市第十一醫(yī)院重癥醫(yī)學(xué)科;
【分類號(hào)】：R563.1;R446.5
【正文快照】： 肺部感染是全球第三大死亡原因〔1〕,其中50%的老年患者因?yàn)楦鞣N病原菌引起的肺部感染死亡,肺部感染的發(fā)病率和死亡率與患者年齡呈正比〔2〕。老年重癥肺炎(SP)患者,除患有肺炎外,還伴有呼吸系統(tǒng)衰竭和(或)其他系統(tǒng)受累;胸部影像學(xué)顯示肺葉大部分受累〔3〕,或發(fā)病危重,入院48

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 周麗玉;馮林焰;林玉貞;;老年重癥肺炎護(hù)理對(duì)策[J];福建醫(yī)藥雜志;2010年01期

2 張蓓;;老年重癥肺炎79例的護(hù)理對(duì)策[J];中國(guó)醫(yī)藥導(dǎo)報(bào);2010年35期

3 梁桂琴;張麗娟;馬愛(ài)芬;米惠茹;;42例老年重癥肺炎患者護(hù)理體會(huì)[J];河北中醫(yī);2011年01期

4 周學(xué)萍;潘朝霞;;專病專護(hù)在護(hù)理老年重癥肺炎中的作用[J];護(hù)理實(shí)踐與研究;2011年20期

5 侯麗芳;;老年重癥肺炎1例的護(hù)理[J];總裝備部醫(yī)學(xué)學(xué)報(bào);2013年02期

6 程書;江漫春;;加強(qiáng)護(hù)理干預(yù)在老年重癥肺炎并發(fā)呼吸機(jī)相關(guān)性肺炎患者中的應(yīng)用[J];安徽醫(yī)藥;2014年07期

7 胡秀瓊;涂艷麗;;護(hù)理干預(yù)對(duì)老年重癥肺炎并發(fā)呼吸機(jī)相關(guān)性肺炎的療效觀察[J];中國(guó)醫(yī)藥指南;2014年14期

8 張敏;李凡;;22例老年重癥肺炎護(hù)理經(jīng)驗(yàn)[J];臨床肺科雜志;2010年12期

9 樓巧珍;張榮;王巍;;老年重癥肺炎患者俯臥位效果觀察及護(hù)理[J];內(nèi)蒙古中醫(yī)藥;2012年22期

10 蔣桂芬;徐怡;;淺談老年重癥肺炎患者的皮膚護(hù)理[J];臨床肺科雜志;2010年12期

相關(guān)會(huì)議論文 前2條

1 朱紅俊;徐俊龍;張劍;;動(dòng)態(tài)監(jiān)測(cè)血清C反應(yīng)蛋白、降鈣素原在老年重癥肺炎患者中的意義[A];2011年浙江省檢驗(yàn)醫(yī)學(xué)學(xué)術(shù)年會(huì)論文匯編[C];2011年

2 唐斌;;老年重癥肺炎并發(fā)ARDS的護(hù)理[A];全國(guó)第七屆老年護(hù)理學(xué)術(shù)交流暨專題講座會(huì)議論文匯編[C];2004年

，

本文編號(hào)：1409030