Gram-negative Bacilli Infection And Drug Resistance In Elderly Patients With Pneumonia In The Medical Intensive Care Unit

Objective: To investigate the infection status of elderly patients with pneumonia and drug resistance of gram-negative bacilli.Methods: A total of 574 Gram-negative bacilli cultures and drug sensitivity test results from 438 elderly pneumonia patients in the intensive care unit of our hospital from January 2015 to October 2018 were selected.According to the World Health Organization(WHO)age classification criteria for the elderly,the study subjects were divided into elderly patients with pneumonia of ?75 years old(old elderly and long-lived elderly)and elderly patients with pneumonia <75 years old(young elderly).Based on the retrospective analysis of the gram-negative bacterial cultures and drug resistance results of different isolates submitted for the first time,the chi-square test was used to explore whether there was any difference in the infection status and bacterial resistance rate.Results: There were 438 elderly pneumonia patients,346 were infected with a single pathogen and 92 were infected with a multiple pathogen.Among them,the same bacteria were cultured for the first time as a research analysis.A total of 258 strains of Acinetobacter baumannii(45%),113 strains of Pseudomonas aeruginosa(19.7%),and 72 strains of Klebsiella pneumoniae(12.4%)were isolated.34 strains of Escherichia coli(5.9%),the number of Gram-negative bacilli strains isolated in the ?75 year old group was more than the <75 year old group.Acinetobacter baumannii isolated in ?75 years old group was more than <75 years old group(p <0.05).The main pathogenic bacterium Acinetobacter baumannii isolated was highly resistant to quinolones,cephalosporins and carbapenems.Other major pathogens also showed high resistance rates to commonly used antibiotics and were multi-drug resistant.There was not much difference in the resistance rate of the same pathogens between the two groups of study subjects.In the analysis within the group,the resistance rate of Pseudomonas aeruginosa to gentamicin in patients with pneumonia infected with pneumonia in patients aged <75 years old was related to multiple bacterial infections.<75 years old patients infection Klebsiella pneumoniaepatients Klebsiella pneumoniae resistance to piperacillin / tazobactam is associated with multiple bacterial infections.Conclusion: Elderly pneumonia patients are seriously infected with gram-negative bacilli,the greater the age,the greater the chance of infection.Acinetobacter baumannii infection has a correlation with the age of the patient,that is,the older the age,the more serious the infection is.Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae,and Escherichia coli are common in hospitals,and they are highly resistant to commonly used antibiotics in the hospital's respiratory department and are multidrug-resistant.There was no significant difference in drug resistance rates between different age groups.There was no significant difference in drug resistance analysis of single pathogen infection / multi-bacteria infection within the group.Elderly patients with pneumonia have difficulties in clinical treatment and their prognosis is poor.