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高龄住院患者抗菌药物使用和细菌耐药性分析

  

  1. 上海市杨浦区市东医院 a.老年科;b.药剂科,上海  200438
  • 出版日期:2018-09-05 发布日期:2018-09-26
  • 通讯作者: 通信作者:倪玲,Email: lovein1981@126.com

Analysis of antibiotic use and bacterial drug resistance in the elderly patients

  1. a. Department of Geriatrics;  b. Department of Pharmacy,  Shanghai Yangpu District
    Shidong Hospital, Shanghai 200438,  China
  • Online:2018-09-05 Published:2018-09-26
  • Contact: Corresponding author: Ni Ling, Email: lovein1981@126.com

摘要: 目的  了解老年科病房内高龄住院患者的抗菌药物使用状况,常见感染部位和病原菌分布及其耐药情况,为高龄患者临床抗感染治疗提供参考。方法  回顾分析2015年1月至2017年12月我院老年科病房使用抗菌药物的病例306例,分离出菌株采用纸片扩展法(KB)进行药敏试验,并按美国临床实验室标准化委员会(CLSI)100标准判断结果。结果  月抗菌药物使用率中1、12月为37.74%和26.56%,明显高于其他月份(P<0.05)。分离菌株数共254株,病原菌以革兰阴性(G-)杆菌居多,占53.54%,革兰阳性(G+)球菌34.65%,真菌11.81%。其中铜绿假单胞菌、大肠埃希菌对哌拉西林/他唑巴坦、厄他培南、亚胺培南敏感性高。未检出对利奈唑胺、万古霉素和利福平耐药的G+菌株。结论  1、12月为高龄老人感染高发期,社区和院内均需做好预防感染措施。高龄患者常见的细菌感染仍以G-菌为主,临床需尽早行细菌培养,选用敏感抗菌药物。

关键词: 抗生素类, 微生物敏感实验, 老年人

Abstract: Objective  To investigate the use of antibiotics,  the distribution of common infection sites and pathogens and their drug resistance in elderly inpatients in geriatric wards,  and to provide reference for clinical antiinfective therapy in elderly patients. Methods  A retrospective analysis was conducted on the of discharged geriatric patients from January 2015 to December 2017, including 306 cases using antibiotics. The susceptibility test of the isolated strain was carried out by disk expansion method (KB),  and the results were judged according to the clsi100 standard.The results were judged according to CLSI100 standard. Results  The monthly antibiotic use rate was 37.74%  in January and 26.56% in December, which was significantly higher than those in other months (P<0.05).The total number of isolated strains was 254. Gramnegative(G-) bacteria accounted for 53.54%,  Grampositive(G+)  bacteria 34.65%, and fungi 11.81%. Pseudomonas aeruginosa, Escherichia coli are highly sensitive to piperacillin,  etapenem and imipenem.No resistance to linazolamine, vancomycin and rifampicin were found in these G+ strains.Conclusion  January and December are highincidence season for infection in the elderly, and community and hospital should make full preparation to prevent it. G- bacteria infection is  still the most common one  in the elderly. Clinically speaking, it is necessary to culture bacteria as early as possible and select sensitive antibiotics.

Key words: antibiotics, microbial sensitivity tests, elderly