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目的了解老年社区获得性肺炎患者的病原学特征。方法选取2000年1月至2004年12月广州市海珠区第一人民医院内科治疗的年龄超过60岁的肺炎患者260例,均在使用抗生素前,采取统一的痰标本采集方法留取痰标本进行病原学检查。结果 260例检测结果中革兰隐性杆菌167例(64.23%),革兰阳性球菌89例(34.23%),真菌4例(1.53%)。药敏检测结果氨基糖甙类抗生素对革兰阴性菌保持较好的抗菌活性,头孢噻肟的耐药率高达70%以上,假单胞菌属致病菌和肺炎克雷伯君对大部分抗生素耐药。青霉素对肺炎球菌的耐药达65%,对金黄色葡萄球菌的耐药达90%,红霉素和环丙沙星对肺炎球菌有较好的抗菌活性,发现1例耐万古霉素的金黄色葡萄球菌感染。结论在基层医院,由于病员结构及来源的特殊性,社区获得性肺炎的病源学特征有别于文献报道的特点,在药物敏感性检测上也表现出相同的特点,提示在基层医院日常工作中,要结合自身实际,具体问题具体分析。
Objective To understand the etiological characteristics of elderly community-acquired pneumonia. Methods From January 2000 to December 2004, the First People ’s Hospital of Haizhu District, Guangzhou, the medical treatment of patients over 60 years of age with pneumonia in 260 cases, before the use of antibiotics, take a uniform sputum specimen collection method for sputum specimens Etiological examination. Results Among the 260 cases, 167 (64.23%) were gram-negative bacilli, 89 (34.23%) were gram-positive cocci and 4 (1.53%) were fungi. Drug sensitivity test results aminoglycoside antibiotics against Gram-negative bacteria to maintain a good antibacterial activity, cefotaxime resistance rate as high as 70%, Pseudomonas and Klebsiella pneumoniae most of the Antibiotic resistance. Penicillin resistant to pneumococcal 65%, resistant to Staphylococcus aureus up to 90%, erythromycin and ciprofloxacin have good antibacterial activity of pneumococcal, found that 1 case of vancomycin-resistant gold Staphylococcus aureus infection. Conclusions In primary hospitals, due to the particularity of the structure and source of patients, the etiological characteristics of community-acquired pneumonia are different from those reported in the literature, and show the same characteristics in drug sensitivity tests, suggesting that in the daily work of primary hospitals To be specific to their own specific problems specific analysis.