To Analysis The Common Pathogenic Bacteria And Their Drug Resistance Of Respiratory Tract Infection In 337 Patients Over 60 Years Old

Objective:To analysis the common pathogenic bacteria and drug resistance rate of respiratory tract infection in patients over 60 years old.Methods:This study included 337 patients who were admitted to the respiratory department of Shengjing hospital affiliated to China Medical University from Jan 1^st,2016 to August 31^st,2017.Then,their sputum samples were collected for microorganism culture and drug sensitive test.Outcome:A total of 337 organism strains were isolated from sputum specimens,included 12 strains of gram-positive coccus（3.56%）and 241 strains of gram-negative bacilli（71.51%）,as well as 84 strains of fungi（24.93%）.The first four gram-negative bacteria were mainly acinetobacter baumannii,pseudomonas aeruginosa,klebsiella pneumoniae,and narrow-phagocytes.The separation rate of gram-positive cocci was low,there were only 9 strains of staphylococcus aureus,2 strains of streptococcus pneumoniae and 1 strain enterococcus.The fungus is mainly candida albicans,with 65 strains,accounting for 77.38%of the total.The non-fermentations were mainly acinetobacter baumannii and pseudomonas aeruginosa.Acinetobacter baumannii was only sensitive to diacycline and amikacin（antibiotic resistant rate,ARR 3.9%and 45.3%）,while It was resistant to other antibiotics（ARR 50%）.Pseudomo nasaeruginosa was resistant to SMZ-TMP（ARR 98.0%）,macrodantin（ARR 96.3%）,ampicillin（ARR 100%）,ampicillin/sulbactam（ARR 91.9%）,cefazolin（ARR 97.9%）,cefotetan（ARR 98.0%）,as well as ceftriaxone（ARR 97.9%）and aztreonam（ARR62.9%）.While it was sensitive to piperacillin/tazobactam（ARR 21.3%）,ceftazidime（ARR 29.0%）and cefepime（ARR27.4%）.Meanwhile,Pseudomonas aeruginosa was also sensitive to aminoglycoside antibiotics and quinolones.The mainly enterobacteriaceae we separate were Klebsiella pneumoniae,escherichia coli,enterobacter cloacae,and myxobacteria.The Klebsiella pneumoniae was resistant to ampicillin（ARR 100%）,cefazolin（ARR 78.3%）,ceftriaxone（ARR 58.3%）,gentamicin（ARR 53.6%）and SMZ-TMP（ARR 53.6%）.On the contrary,It was sensitive to Piperacillin/Tazobactam（ARR 14.3%）,aztreonam（ARR42.9%）,macrodantin（ARR 30.8%）,cefotetan（ARR 8.3%）,ceftazidime（ARR 25.0%）,cefepime（ARR 25.0%）,imipenem and ertapenem（ARR 3.6%and 0 respectively）.Meanwhile,it was also sensitive to amikacin and tobramycin（ARR 14.3%and 29.2%,respectively）as well as ciprofloxacin and levofloxacin（ARR 28.6%and 25.0%,respectively）.Staphylococcus aureus was totally resistant to the antibiotics we used to defense gram positive coccus,such as penicillin G and erythromycin.And it was highly resistant to benzoxazole,tetracycline,clindamycin,ciprofloxacin.Luckily,there were some types of antibiotics such as SMZ-TMP,gentamicin,rifampicin,especially vancomycin,linezolid,and tiagocycline that we can use to defense staphylococcus aureus.Conclusion:The mainly microorganism we separated from sputum was bacteria.There was a serious case that most of the bacteria we acquired were drug resistance.The majority of the bacterial strains were resistant to some antibiotics we used frequently.In addition,some of the bacteria strains in this study were characterized by multidrug resistance or pan-drug resistance.Particularly,they were resistant to some of the“top level”antibiotics.Above all,it is necessary to reasonably prevent and manage infectious diseases.This study provides a basis for the rational selection of antimicrobial agents in the elderly population by understanding the bacterial strains and their drug resistance.