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目的：研究老年慢性支气管炎患者合并下呼吸道感染病原菌分布以及耐药性。方法：选取2009 年1 月到2013 年12 月我院收治的老年慢性支气管炎患者合并下呼吸道感染患者261 例，采集所有患者的痰液，然后进行病原菌鉴定和药敏试验。结果：261 例患者中，144 例革兰阴性杆菌感染（55.2%），51 例革兰阳性杆菌感染（19.5%），66 例真菌感染（25.3%），其中混合感染者36 例（13.8%）。革兰阴性杆菌以肺炎克雷伯菌最多（18.4%），革兰阳性杆菌以金黄色葡萄球菌最多（9.2%）。革兰阴性杆菌对亚胺培南的耐药性最低，其次是头孢哌酮和阿米卡星，对氨苄西林耐药率最高。金黄色葡萄球菌和表皮葡萄球菌对青霉素的耐药率均为 100.0%，均对万古霉素敏感，其次是对环丙沙星敏感。结论：老年慢性支气管炎患者合并下呼吸道感染以革兰阴性杆菌感染为主，真菌和混合感染也占一定的比例，应该引起注意。

英文摘要:

Objective:To study the distribution and drug resistance of pathogenic bacteria in elderly patients with chronic bronchitis combined with lower respiratory tract infection.Methods:261 elderly patients with chronic bronchitis combined with lower respiratory tract infection admitted in our hospital from January 2009 to December 2013 were enrolled in this study. The sputum of patients were collected and conducted pathogen identification and drug sensitive test.Results:Among the 261 patients, 144 infected with gramnegative bacilli which accounted for 55.2%, 51 infected with gram positive bacteria which accounted for 19.5%, 66 mainly infected with fungus which accounted for 25.3%, and 36 were combined infection which accounted for 13.8%. The majority of gram negative bacilli was klebsiella pneumonia which accounted for 18.4%, and the majority of gram positive bacteria was staphylococcus aureus which accounted for 9.2%. The drug resistance of gram negative bacilli to Imipenem was the lowest, followed by Cefoperazone and Amikacin, with the highest to Ampicillin. Staphylococcus aureus and staphylococcus epidermidis were 100.0%resistant to Penicillin, and all sensitive to Vancomycin, followed by Ciprofloxacin.Conclusion:The majority of lower respiratory tract infection in elderly patients with chronic bronchitis was gram negative bacilli, and there were also certain percentages of fungus and combined infection, which should be paid attention to.

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