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目的对医院获得性肺炎(HAP)老年患者病原菌测定、耐药性及危险因素探讨,为临床合理用药及控制院内感染提供依据。方法回顾性分析1 378例HAP老年患者的临床资料。结果 1 378例HAP老年患者共分离病原菌1 875株,主要是革兰阴性杆菌1 143株(占61.0%),以铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌等为主;其次是革兰阳性球菌578株(占30.8%),以金黄色葡萄球菌为主,其中耐甲氧西林金黄色葡萄球菌(MRSA)211株(占74.3%);真菌154株(占8.2%),以白色念珠菌为主。常见病原菌耐药性较高;与发病有关独立危险因素有呼吸机使用、基础类疾病严重、慢性肺病、误吸、意识状态较差等。结论 HAP老年患者常见病原菌耐药性较高,应依据药敏试验结果合理用药。
Objective To investigate pathogenic bacteria, drug resistance and risk factors of elderly patients with hospital acquired pneumonia (HAP), and to provide evidences for rational clinical use and control of nosocomial infections. Methods The clinical data of 1 378 HAP elderly patients were retrospectively analyzed. Results A total of 1 875 pathogens were isolated from 1 378 elderly patients with HAP, including 1 143 strains of Gram-negative bacilli (61.0%), Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Followed by Gram positive cocci 578 (30.8%), mainly Staphylococcus aureus, of which methicillin-resistant Staphylococcus aureus (MRSA) 211 (74.3%); fungi 154 Strain (8.2%), mainly Candida albicans. Common pathogens higher resistance; associated with the incidence of independent risk factors are ventilator use, basic type of disease is serious, chronic lung disease, aspiration, poor awareness of the state. Conclusion HAP elderly patients with high prevalence of pathogens should be based on drug susceptibility test results rational use of drugs.