内蒙古包头地区老年人群感染病原菌分布及其耐药性

Distribution and drug resistance of pathogens isolated from the elderly population with infections in Baotou area, Inner Mongolia

  • 摘要:
    目的 分析内蒙古包头地区老年人群感染病原菌分布特征及耐药性情况。
    方法 回顾性分析包头医学院中心临床医学院和包头医学院第二附属医院2017-2021年9 268例老年感染患者(年龄≥60岁)的临床资料, 对9 268份样本进行分离、菌种鉴定和药敏试验。
    结果 共分离病原菌9 268株, 革兰阴性菌占53.11%, 主要为大肠埃希菌和肺炎克雷伯菌;革兰阳性菌占28.94%, 主要为肠球菌和凝固酶阴性葡萄球菌;真菌占17.95%, 主要为白色念珠菌。不同性别、季节及年龄段的老年患者感染病原菌存在一定差异。耐药性方面, 革兰阳性菌对万古霉素和替考拉宁保持高敏感, 而对氨苄西林和青霉素耐药率较高;革兰阴性菌对碳青霉烯类药物耐药性较低, 但对氨苄西林与头孢唑林耐药性较高。
    结论 内蒙古包头地区老年人群感染病原菌以革兰阴性菌为主, 病原菌分布受性别、年龄与季节因素影响。病原菌耐药性问题突出, 对常用抗菌药物如氨苄西林、青霉素等耐药性较强。临床应针对不同病原菌的流行特征和耐药性趋势, 合理使用抗菌药物, 优化感染性疾病的临床诊疗策略。

     

    Abstract:
    OBJECTIVE To investigate the distribution and drug resistance of pathogens isolated from the elderly population with infections in Baotou, Inner Mongolia.
    METHODS The clinical data were collected from 9268 elderly patients with infections (with no less than 60 years of age) who were treated in Baotou Medical College of Center Clinical Medical School and the Second Affiliated Hospital of Baotou Medical College from 2017 to 2021 and were retrospectively analyzed. The 9268 samples were cultured for isolation of pathogens, the isolated pathogens were identified, and the drug susceptibility testing was performed.
    RESULTS Totally 9268 strains of pathogens were isolated, 53.11% of which were gram-negative bacteria, 28.94% were gram-positive bacteria, and 17.95% were fungi. Escherichia coli and Klebsiella pneumoniae were the major species of gram-negative bacteria; Enterococci and coagulase-negative Staphylococcus were dominant among the gram-positive bacteria; Candida albicans was the predominant species of fungi. There were certain differences in the pathogens isolated from the elderly patients with infection between different sexes, among the different seasons and age groups. With respect to drug resistance, the gram-positive bacteria maintained highly sensitive to vancomycin and teicoplanin, while the drug resistance rates to ampicillin and penicillin were relatively high. The drug resistance rates of the gram-negative bacteria to carbapenems were relatively low, but the drug resistance rates to ampicillin and cefazolin were high.
    CONCLUSIONS The gram-negative bacteria are dominant among the pathogens isolated from the elderly population with infections in Baotou City, Inner Mongolia; the distribution of pathogens is affected by the sex, age and season. There is serious problem with the drug resistance of pathogens, the strains are highly resistant to the commonly used antibiotics such as ampicillin and penicillin. It is necessary for the hospital to reasonably use antibiotics according to the epidemiological characteristics and drug resistance trends of the pathogens and optimize the strategies for clinical diagnosis and treatment of infectious diseases.

     

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