RESUMO
Objective To investigate the distribution of pathogens and their drug resistance in elderly patients with community-acquired pneumonia. Methods A total of 222 elderly patients with community-acquired pneumonia admitted to our hospital from February 2017 to January 2018 were enrolled in this study.Lower respiratory tract secretions or morning sputum were collected by using the sterile culture method. According to the clinical microbiological examination procedures ,pathogenic bacteria were cultured and identified. The pathogenic bacteria strains and the drug resistance were analyzed. Results The bacteria examination rate of the patients was 100.0% (222/222 patients) , and the rate of positive cultures was 64.9% (144/222 ).216 strains of pathogenic bacteria were identified ,and 75 strains(34.7% )were Gram-positive bacteria ,of which the most common pathogenic bacteria were Staphylococcus aureus ,Streptococcus pneumoniae and Staphylococcus epidermidis. And 127 strains(58.8% )were Gram-negative bacteria ,of which the most common pathogenic bacteria were Klebsiella pneumoniae ,patina Pseudomonas ,Escherichia coli ,Stenotrophomonas maltophilia and Haemophilus influenza. The drug susceptibility test showed that Gram-positive bacteria were sensitive to nitrofurantoin ,cotrimoxazole ,vancomycin and teicoplanin ,and Gram-negative bacteria were sensitive to piperacillin ,tazobactam ,cefepime ,amikacin ,levofloxacin and imipenem cilastatin. Conclusions The pathogenic bacteria are mainly Gram-negative bacteria in the elderly patients with community-acquired pneumonia ,but the majority of pathogenic bacteria have higher resistance to antibacterial drugs. The analyses of distribution of pathogens and their drug resistance are of great significance for the reasonable selection of antimicrobial agents and for the obvious decrease of lung infection and mortality rate.
RESUMO
Objective To investigate the effect of tigecycline on serum procalcitonin and its efficacy in the treatment of elderly chronic obstructive pulmonary disease (COPD) and nosocomial infection. Methods 82 elderly patients with COPD with nosocomial infection were selected and randomly divided into two groups with 41 cases of each group, the control group received routine treatment combined with cefoperazone and sulbactam, and the experimental group received routine treatment combined with tigecycline, 2 weeks for a course of treatment. The serum inflammatory factors and laboratory related indexes, clinical efficacy and bacterial clearance were compared after the treatment. Results Compared with control group, the levels of serum high-sensitivity C-reactive protein (hs-CRP), interluekin 6(IL-6) and tumor necrosis factorα(TNF-α) were significantly lower, and the serum levels of PCT and NO were lower(P < 0.05). The total efficacy of experimental group was 90.24%, which was higher than 70.73% in control group (P<0.05). The bacterial clearance rate in the control group was 63.42%, which was lower than the experimental group of 87.80% (P < 0.05). Conclusion Tigecycline in the treatment of COPD and nosocomial infection in elderly patients is curative effective and it can reduce the serum levels of PCT, NO and inflammatory factors with high safety.