Page 135 - 北京京煤集团总医院第十届·2022学术年会论文集

北京京煤集团总医院 第十届·2022 学术年会论文集

急诊留观老年社区获得性肺炎患者病原学分析

王娇（北京京煤集团总医院急诊科，北京 102300）

【摘要】目的：探究急诊留观老年患者社区获得性肺炎常见病原学及感染特点。方法：选取

北京京煤集团总医院 2020 年 3 月至 2021 年 10 月诊断为社区获得性肺炎的 79 例急诊留观
老年患者进行回顾性分析，采取合格痰标本，对常见病原学进行分析，并对混合感染与单细

菌感染患者的临床特点进行比较，将单因素分析差异有统计学意义的变量纳入 logistic 多因

素回归分析。结果：老年社区获得性肺炎患者中，肺炎克雷伯菌、铜绿假单胞菌等革兰阴性

杆菌检出率较高，鲍曼不动杆菌耐药率高。单因素分析结果显示，混合感染与依赖胃管、尿

管、卧床状态、抗生素滥用史、呼吸系统疾病、2 型糖尿病、多重耐药菌感染有关，差异有

统计学意义（P<0.05） 。 logistic 回归模型进行多因素分析结果显示，2 型糖尿病（ß=2.166，

OR=8.723，95%CI=2.195～34.671），多重耐药菌感染（ß=1.749，OR=5.746，95%CI=1.166～

28.323）为混合感染的独立危险因素（P<0.05）。结论：老年患者社区获得性肺炎分离细菌

出现与医院获得性肺炎细菌类似细菌谱，2 型糖尿病和多重耐药菌感染是混合感染的独立危

险因素。

【关键词】社区获得性肺炎；老年人；病原学；抗生素滥用

Etiological analysis of elderly patients with community-acquired pneumonia in emergency

department
[Abstract] Objective To study the common etiology and infection characteristics of community-

acquired pneumonia in elderly patients in emergency department. Methods A total of 79 elderly

patients who were diagnosed with community-acquired pneumonia in the emergency department of

Beijing Jingmei Group General Hospital from March 2020 to October 2021 were retrospectively

analyzed. Qualified sputum samples were taken, common etiology was analyzed, the clinical

characteristics of patients with mixed infection and single bacterial infection were compared. The

variables with statistically significant difference in univariate analysis were included in logistic

multivariate regression analysis. Results The detection rate of Gram-negative bacilli such as

Klebsiella pneumoniae and Pseudomonas aeruginosa were higher in elderly patients with

community-acquired pneumonia. Acinetobacter baumannii has a high drug resistance rate. The

results of univariate analysis showed that mixed infection was related to dependence on gastric tube,

urinary tube, bedridden status, history of antibiotic abuse, respiratory disease, type 2 diabetes, and

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