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目的:通过分析社区获得性肺炎(CAP)老年患者痰培养及药敏试验,了解当前CAP病原菌的分布及耐药情况。方法:分析2008年1月～12月我院诊断为老年社区获得性肺炎住院患者送检的73例痰培养的病原菌及药敏试验。结果:73例中共分离出病原菌60株,17个菌种。其中革兰氏阴性杆菌占79%,革兰氏阳性球菌占21%,7例阳性标本中同时培养出真菌,占12%。革兰氏阴性杆菌对亚胺培南仍有高敏感性(95%～100%),其次对头孢哌酮/舒巴坦钠、头孢噻肟、左旋氧氟沙星、丁胺卡那霉素等敏感性也较高(67%～89%),对氨苄西林耐药性最高达95%。而革兰氏阳性球菌对万古霉素的敏感性高达100%,对氨苄西林的耐药性亦高达80%。结论:引起老年社区获得性肺炎的致病菌以革兰氏阴性杆菌为主,对头孢哌酮/舒巴坦钠、头孢噻肟、左旋氧氟沙星、丁胺卡那霉素等药物敏感,而对氨苄西林、头孢唑林、头孢呋辛、阿奇霉素等耐药性高。
OBJECTIVE: To understand the distribution and drug resistance of pathogens in CAP by analyzing sputum culture and drug susceptibility test in senile patients with community-acquired pneumonia (CAP). Methods: From January to December in 2008, 73 cases of sputum culture pathogenic bacteria and drug susceptibility test in our hospital were collected for diagnosis of senile community-acquired pneumonia inpatients. Results: There were 60 pathogens and 17 strains isolated from 73 Chinese Communists. Among them, Gram-negative bacilli accounted for 79%, Gram-positive cocci accounted for 21%, and 7 positive specimens also cultivated fungi, accounting for 12%. Gram-negative bacilli are still highly sensitive to imipenem (95% -100%), followed by cefoperazone / sulbactam sodium, cefotaxime, levofloxacin, amikacin The sensitivity is also high (67% ~ 89%), the highest resistance to ampicillin up to 95%. Gram-positive cocci is as high as 100% susceptible to vancomycin and up to 80% more resistant to ampicillin. CONCLUSIONS: Gram-negative bacilli are the main pathogenic bacteria in elderly community-acquired pneumonia. They are sensitive to cefoperazone / sulbactam sodium, cefotaxime, levofloxacin and amikacin , While ampicillin, cefazolin, cefuroxime, azithromycin and other high resistance.