[1]杜 晶,张竹青,马春梅,等.老年急性呼吸衰竭合并肺部感染患者病原菌分布特点、耐药性及血清白介素-6、白介素-10水平变化临床意义[J].陕西医学杂志,2023,52(10):1354-1357.[doi:DOI:10.3969/j.issn.1000-7377.2023.10.015]
　DU Jing,ZHANG Zhuqing,MA Chunmei,et al.Distribution and drug resistance of pathogenic bacteria in elderly patients with acute respiratory failure complicated with pulmonary infection and clinical significance of changes in serum IL-6 and IL-10 levels[J].,2023,52(10):1354-1357.[doi:DOI:10.3969/j.issn.1000-7377.2023.10.015]
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老年急性呼吸衰竭合并肺部感染患者病原菌分布特点、耐药性及血清白介素-6、白介素-10水平变化临床意义
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年10期
页码:
1354-1357
栏目:
临床研究
出版日期:
2023-10-05

文章信息/Info

Title:
Distribution and drug resistance of pathogenic bacteria in elderly patients with acute respiratory failure complicated with pulmonary infection and clinical significance of changes in serum IL-6 and IL-10 levels
作者:
杜 晶; 张竹青; 马春梅; 李红永
(西部战区总医院感染科,四川 成都 610083)
Author(s):
DU Jing; ZHANG Zhuqing; MA Chunmei; LI Hongyong
(Department of Infection,Western War Zone General Hospital,Chengdu 610083,China)
关键词:
老年急性呼吸衰竭;  肺部感染;  病原菌分布;  耐药性;  白介素-6;  白介素-10
Keywords:
Elderly acute respiratory failure;  Pulmonary infection;  Distribution of pathogenic bacteria;  Drug resistance;  Interleukin-6;  Interleukin-10
分类号:
R 563.8
DOI:
DOI:10.3969/j.issn.1000-7377.2023.10.015
文献标志码:
A
摘要:
目的:探讨老年急性呼吸衰竭(RF)合并肺部感染患者病原菌分布特点、耐药性及血清白介素-6(IL-6)、白介素-10(IL-10)水平变化的临床意义。方法:回顾性分析98例老年急性RF患者临床资料,依据是否并发肺部感染分为感染组(n=58)与未感染组(n=40),分析感染组病原菌分布、耐药性,并比较两组实验室指标数据。结果:感染组58例患者共培养病原菌67株,其中革兰阳性菌15株,占22.39%,革兰阴性菌48株,占71.64%,真菌4株,占5.97%。主要革兰阳性菌对红霉素、呋喃妥因、新诺明较敏感,主要革兰阴性菌对阿米卡星、头孢哌酮、亚胺培南较敏感。感染组血清IL-6、IL-10水平及肺部感染评分(CPIS)均高于未感染组,差异具有统计学意义(均P<0.05); 经Spearman相关性分析,血清IL-6、IL-10水平与CPIS评分均呈正相关(均P<0.05)。结论:老年急性RF合并肺部感染患者病原菌主要为革兰阴性菌,且对抗菌药物具有一定耐药性,临床治疗时应依据药敏试验合理运用抗生素,且合并肺部感染患者血清IL-6、IL-8水平升高,临床可将上述指标作为疾病监测指标。
Abstract:
Objective:To investigate the distribution and drug resistance of pathogenic bacteria in elderly patients with acute respiratory failure(RF)complicated with pulmonary infection,and analyze the clinical significance of of changes in serum interleukin-6(IL-6)and interleukin-10(IL-10).Methods:The clinical data of 98 elderly patients with acute RF were reviewed.They were divided into infected group(n=58)and uninfected group(n=40)according to whether they were complicated with pulmonary infection.The distribution and drug resistance of pathogenic bacteria in the infected group were analyzed.Laboratory indicators were compared between groups.Results:A total of 67 pathogenic bacteria strains were obtained from the infected group,including 15(22.39%)strains of Gram-positive bacteria,48(71.64%)strains of Gram-negative bacteria and 4(5.97%)strains of fungi.The main Gram-positive bacteria were more sensitive to erythromycin,furantoin and sulfamethoxazole,while the main Gram-negative bacteria were more sensitive to amikacin,cefoperazone and imipenem.Serum IL-6 and IL-10 levels and the Clinical Pulmonary Infection Score(CPIS)in the infected group were higher than those in the uninfected group(all P<0.05).Spearman correlation analysis showed that serum IL-6 and IL-10levels were positively correlated with the CPIS score(all P<0.05).Conclusion:The pathogens in elderly patients with acute RF complicated with pulmonary infection are mainly Gram-negative bacteria,and they have a certain resistance to antibiotics.Antibiotics should be rationally used according to drug sensitivity test during clinical treatment.

参考文献/References:

[1] 康 睿,刘慧霞.肺部感染控制窗序贯通气在慢性阻塞性肺疾病急性加重期合并呼吸衰竭治疗中的应用价值研究[J].陕西医学杂志,2022,51(3):342-346.
[2] 陈瑞琳,张程程,武润苗,等.重症肺部感染患者血清炎性因子、凝血功能及SchE水平的变化及意义[J].国际呼吸杂志,2019,39(1):22-25.
[3] 吴 爽,王宏君,陈 琛,等.通腑益气平喘汤联合西药对慢性阻塞性肺疾病急性发作合并呼吸衰竭患者血气状态及机体微炎症反应的影响[J].陕西中医,2020,41(12):1735-1738.
[4] 宋玉龙,侯 伟,金 茜.慢性阻塞性肺疾病患者急性加重期合并肺部感染的病原菌分布及危险因素分析[J].工业卫生与职业病,2019,45(3):227-228,231.
[5] 林桐梅,赵慧艳,郝亲薄.冠心病PCI术后肺部感染病人血清E选择素、IL-6、IL-8、CRP水平表达及临床意义[J].中西医结合心脑血管病杂志,2021,19(20):3553-3555.
[6] 刘 燕,宋昳星,王丹阳,等.外周血CD8+CD28-T细胞Foxp3 mRNA表达与老年肺部感染的关系[J].中华医院感染学杂志,2022,32(7):971-975.
[7] 董声焕.呼吸衰竭基础与临床[M].北京:人民军医出版社,1992:156-159.
[8] 中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):314-320.
[9] 中华人民共和国卫生部司政司.全国临床检验操作规程[M].4版.北京:人民卫生出版社,2015:636-638.
[10] Bobenchik AM,Hindler JA,Gilrtner CL,et al.Performance of vitek 2 for antimicrobial susceptibility testing of Staphylococcus spp.and Enterococcus spp[J].J Clin Microbiol,2014,52(2):392-397.
[11] Pugin J,Auckenthaler R,Mill N,et al.Diagnosis of ventilator-associated pneumonia by bacteriologic analysis of bronchoscopic and nonbronchoscopic “blind” bronchoalveolar lavage fluid[J].Am Rev Respir Dis,1991,143(5):1121-1129.
[12] 沈永霞,胡 敏,张 燕,等.高流量氧疗对老年肿瘤患者术后急性呼吸衰竭的疗效和预后影响[J].川北医学院学报,2022,37(10):1309-1312.
[13] 梁 艳.某院74例呼吸衰竭合并肺部感染患者的病原菌分布及主要病原菌的耐药性分析[J].抗感染药学,2021,18(9):1261-1264.
[14] 杨 兰,李春明,李 莎.老年卒中合并肺部感染患者的病原菌分布和耐药性及预防策略分析[J].实用医院临床杂志,2018,15(4):190-193.
[15] 聂晓红,朱鹏飞,张 剑,等.老年慢性阻塞性肺疾病急性加重合并肺炎病原菌及多重耐药菌分析[J].华西医学,2017,32(11):1708-1712.
[16] 韩林华.老年髋部骨折合并肺部感染的病原菌及相关因素分析[J].中国煤炭工业医学杂志,2019,22(3):271-274.
[17] 武红莉,田瑞雪,宁兰丁,等.慢性阻塞性肺疾病患者肺部感染的影响因素分析及血清炎症因子水平变化分析[J].中华医院感染学杂志,2018,28(1):25-28.
[18] 柏 梅,敬 梅,路晓艳,等.CPIS评分及血清PCT在慢性阻塞性肺疾病呼吸机相关性肺炎诊断和预后判断中的应用价值[J].临床和实验医学杂志,2018,17(15):1617-1620.
[19] 胡灿芳,罗国君,唐春雷,等.老年脑卒中后认知功能障碍合并肺部感染患者病原菌分布、炎症因子水平变化及危险因素分析[J].临床军医杂志,2021,49(1):81-82.

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备注/Memo

备注/Memo:
基金项目:四川省自然科学基金资助项目(2023NSFSC0742)
更新日期/Last Update: 2023-10-07